Palarum’s PUP (Patient is UP) Smart Socks have built-in pressure sensors that detect when a patient is trying to stand up unassisted, and alert the closest nurses. In a recent study, the device dramatically reduced falls among patients in a Columbus hospital. Credit: Brian Berger | Reborn StudiosBrian Berger | Reborn Studios

CLEVELAND, Ohio — Up to 1 million Americans across the country suffer falls while in hospitals, risking broken bones and head trauma.

In Columbus, a hospital reduced falls to zero in a select group of patients by giving them smart socks that detected when they were getting up unassisted. The average fall rate at the hospital, ahead of the study, was four falls per 1,000 patient days.

The wireless socks have built-in pressure sensors that detect when a patient is trying to stand up, and alert the closest nurses. In a recent study, the device dramatically reduced fall rates among patients identified as at-risk for falls at the Ohio State University Brain and Spine Hospital.

In fact, none of the patients fell while wearing PUP (Patient is UP) Smart Socks during the study.

“This alerting mechanism is more reliable and more accurate, and helps nurses get in there in time to help prevent those patients from falling,” said Palarum CEO & founder Patrick Baker.

The smart socks tested at OSU — developed by the Cincinnati-based Palarum — are made with conductive yarn, with sensors woven into the sock, Baker said.

When the FDA-approved smart socks detect that a patient is getting out of bed without assistance, the three closest nurses receive an alert through special badges they wear. Alerts are sent to additional nurses if no one responds quickly. When a nurse with a badge then enters the patient’s room, the alert is automatically deactivated.

In the OSU study, the median nurse response time was 24 seconds.

“It was great that no one fell, but I was probably just as equally impressed with the fact that our staff were responding to these alarms so much quicker,” said study senior investigator Tammy Moore, associate chief nurse of Ohio State’s Neurological Institute and Medical Surgical. “We definitely have more study to do with this. But we were highly encouraged by what we saw.”

The OSU study enrolled more than 500 patients in OSU’s neurological and neurosurgical units over 13 months. These units specialize in stroke, orthopedics, neurosurgery, general neurology and epilepsy patients.

The study originally planned to enroll 2,500 patients, but it ended early because some of the hospital units in the study were converted to COVID-19 patient beds during the pandemic. All participants were issued the PUP Smart Socks.

“While I understand all the limitations of a very small study, it gave me great clinical hope that this could be something that could make a difference and with our patients,” Moore said.

OSU’s Smart Sock study was recently published online in the Journal of Nursing Care Quality.

Between 700,000 and 1 million Americans suffer a fall while hospitalized each year, according to government statistics. Elderly patients are most at risk, especially those with delirium, or decreased mobility, balance or strength.

Even when a patient isn’t hurt by a fall, it can lead to anxiety and cause the older person to be less active, leading to loss of strength and independence.

Baker was vice president and chief nursing officer at University of Cincinnati Health System West Chester Hospital when he realized that patients and hospitals needed a better way to prevent patient falls.

His degrees in nursing and hospital finance and administration made him aware of the dangers of patient falls, and why bed and chair alarms weren’t the best solutions.

“I thought, ‘Why can’t we create a smart sock?,’ ” he recalled. He left UC and later started Palarum in 2016.

Hospitals purchase the sock device in a package that includes caregiver’s badges and tablets that connect to Palarum’s servers. The system is not available for home use.

PUP Smart Socks are less expensive than some high-tech systems used to prevent hospital falls, Baker said. The device costs about $11 per day per patient, compared with $300 per day for video monitors and as much as $960 per day for patient sitters.

Patients in the OSU trial were not charged for the smart socks.

The FDA-approved smart socks soon will be in use in six U.S. hospitals, Baker said. None are in the Cleveland area.

OSU will soon roll out these socks on six inpatient units throughout the medical center to see if the fall reduction rate seen in the earlier study is repeated.

“Anybody with high fall risk, we’re going to put the socks on them,” Moore said.

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