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PUP (Patient is Up) Socks Technology

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medgadget.com
Author: Conn Hastings, PhD

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medgadget.com article: August 25th, 2022

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This current innovation was produced and promoted by Palarum, LLC.  The founder of the company is a previous Chief Nursing Officer from a large community hospital.

PUP (Patient is Up) Smart Socks technology was developed to create an increase in patient satisfaction, decrease in nurse alarm fatigue, and ultimately a reduction in patient falls, leading to a decrease in the cost to healthcare facilities due to falls resulting in injury.

According to the PUP Smart Socks Whitepaper provided by Palarum, LLC, the Smart Socks are embedded with sensors woven into the bottom of the socks. These sensors measure any changes in movement and pressure in real time. The PUP system analyzed nine separate data points collected from the socks to validate whether or not a patient is standing or walking unassisted. If a fall-risk patient attempts to get up, the PUP Smart Sock triggers an alert on the in-room tablet. A series of electronic beacons scattered throughout the hospital unit then transmits this alert to the master tablet, located at the nurse's station.  The alarm notification system then finds the three nurses closest to the patient room via smart badges.  Once the nurse enters the room the system automatically deactivates all alarms for that particular incident. (PUP Smart Socks Whitepaper, accessed 2023)

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Video regarding PUP technology

https://youtu.be/46ku5rfXOpw

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1. Cost of technology. Although, I could not find the actual pricing, there are multiple components to this innovation that lead me to believe it would be cost prohibitive for most healthcare facilities.

2. I was able to locate two articles that had been published in journals.  There was one full article available for review with the link found on the Palarum, LLC website (www.palarum.com). This article disclosed that all authors were employees of Palarum, LLC. The article also indicated that Palarum, LLC, funded the studies, research and development (Baker, 2021).  I was unable to gain full access to the other article but was able to view enough to realize it was a similar study article but written by persons from the facility where the Smart Socks were trialed (Moore, 2023).  With only these two articles available, I do not believe there has been enough research on this product to justify its use when there are alternatives available to prevent falls.

3. A press release was written in 2020 that the US Veterans Affairs and Palarum, LLC announced they had entered into a Cooperative Research and Development Agreement Program (CRADA) to evaluate the product, but there is no follow-up on the outcome. (www.newswire.com, 2020)

4. The PUP Smart Socks Whitepaper indicated this technology could be integrated with Electronic Medical Records (EMR). I need additional information on this, as it leads me to believe that safety events are automatically entered into the patient EMR and, although nurses document incidents anyway, I would like to know what the documentation looks like to ensure we are not integrating information that could lead to legal action.

5. The PUP Smart Socks Whitepaper provided information that states only nurses were provided with the Smart badges for alerts.  I am curious if they would also be provided to nurse aides who work on the unit as this would be a major benefit if nurses are unavailable.

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1. During the clinical trial, wearing the smart socks reduced falls from 4 to 0 per 1,000 patient-days (p < 0.01) and in the observational study wearing the smart socks resulted in a reduction of falls from 4 to 1.3 per 1,000 patient days (p < 0.05) (Baker, 2021). The results of this study indicated a significant reduction in the number of falls when patients wore the smart socks.

2. Designed by nurses for nurses (PUP Smart Socks Whitepaper, accessed 2023), the product has the advantage of being developed by professionals with frontline experience with patient care and falls.

3. System alerts the three closest smart notification devices worn by caregivers (PUP Smart Socks Whitepaper, accessed 2023). This technology could potentially assist in the reduction of medical alarms that can create alarm fatigue in hospital staff.

4. The researchers found the Smart Sock system resulted in only 0.22% false alarms, which is extremely low (Baker, 2021).  This could potentially assist in the reduction of medical alarms that can create alarm fatigue in hospital staff.

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Although the PUP Smart Socks seem to be an innovation of use in the reduction of falls, I would like to see additional data from studies performed and a cost analysis before we can propose this to the Administrative Team.

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Jessica Stewart's Top Five (5) Strengths by CliftonStrengths and How They Will Help My Team

1. Input - As my team builds the case for adoption of this innovation, I will be able to help the team by collecting as much information as possible on this technology. I will be knowledgeable about the product with an excellent memory and mind for detail.
2. Learner - This strength will allow me to enhance my Input strength by catching on quickly to what the product will provide and learning everything possible about this item.
3. Positivity - This strength will help my team by increasing their enthusiasm for this project and building them up with praise on their contributions.
4. Achiever - When the team is feeling frustrated, overwhelmed, angry, or disappointed, I will be able to lighten the mood with my quick wit.
5. Intellection - I can add precision when I am able to concentrate on the small, factual details of the product's description for use.

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Baker, P. A., Roderick, M. W., & Baker, C. J. (2021). PUP
(Patient Is Up) Smart sock technology prevents falls
among hospital patients with high fall risk in a clinical
trial and observational study. Journal of Gerontological
Nursing, 47(10), 37-43. https://palarum.org/wp-
content/uploads/2022/10/jgnpdf.pdf

Hastings, C. (2022, August 25). Smart Socks Help Prevent
Falls Among At-Risk Patients. Medgadget.
https://medgadget.com/2022/08/smart-socks-help-
prevent-falls-among-at-risk-patients.html

Moore, T., Kline, D., Paletas, M., & Bodine, T. (2023). Fall
prevention with the smart socks system reduces
hospital fall rates. Journal of Nursing Care Quality,
38(1), 55-60.

Palarum Announces US Veteran Affairs to Evaluate Use of
'Smart Patient Sock' to Reduce Patient Falls. (2020,
November 16). Newswire.
https://www.newswire.com/news/us-veterans-affairs-
to-evaluate-use-of-smart-patient-sock-to-reduce-
21256241

PUP Smart Socks Whitepaper. (Accessed 2023)
https://palarum.org/wp
content/uploads/2022/10/whitePaper20.pdf

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I am first choosing Sheila, whose top strength is Strategic for my team.  I believe she will be a great addition as she has good judgement, can identify risks, and makes solid decisions, which we will need as we move forward with evaluating this product.

My second choice is Angelica, whose top strength is Analytical and has the ability to think about all factors that might affect the introduction of this product into our facility.  Although, she can potentially be rude and tough, I can offset this with my strength of Positivity.

The third team member will be Abraham as his top strength is Arranger.  It will be beneficial to have them on the team as he can figure out how all the pieces and resources for this project can be arranged for maximum productivity.  Although some of his basement descriptors indicate he lacks structure and doesn't follow the existing rules or procedures, my Intellection strength means I am also known for adhering to prescribed policies, procedures, or standards and would make a good balance.

The fourth member of the team will be Carter whose top strength is Communication.  It will be great to have someone on the team that finds it easy to put their thoughts into words, is a good presenter and will be able to relay the information from our findings to the Administrative Team.

The fifth team member will have the top strength of Individualization and will be able to pull the team together to work productively.  Ivy will appreciate the difference in all of these team members and will see their uniqueness.