Systematic Review and Meta‐Analyses of Mobilization Alarms for Prevention of Falls in Hospital
Terry P. Haines, Kelly Stephen, Ravi Manohar, Hanne Dolan, Meghan Campbell, Alison Bravington, Ronald I. Shorr, Dai PuABSTRACT
Background
Accidental falls are a common and costly adverse event among hospital patients. Mobilization alarms are used for their prevention however research findings vary between strong favorable effects and harmful effects. We sought to establish the effectiveness of mobilization alarms for the prevention of inpatient falls; identify effect modifiers and sources of design‐related bias that may be confounding this field.
Methods
Systematic review of English‐language publications with no year limit restrictions using databases Medline, Embase, CINAHL, and Scopus; last searched on February 16, 2026. Two independent reviewers selected publications focused on alarm systems for the prevention of falls among adult hospital inpatients. Three reviewers extracted data related to study outcomes along with effect modifiers and potential sources of design‐related bias. We followed PRISMA reporting guidelines. We undertook meta‐analyses of RCTs and non‐RCTs; examined potential effect modifiers and sources of design‐related bias, then expanded the analyses to a broader range of factors in univariate and multiple meta‐regression analyses, and exploratory analyses of time‐series data to address the research objectives. The primary outcomes were rates of falls (ratio and mean difference), falls resulting in injury, and proportion of patients becoming fallers.
Results
Pooled incidence rate ratio (95% CI) of falls when exposed to alarms when just considering RCTs ( n = 13 comparisons, 11 studies) was 0.93 (0.83 to 1.04); and for injurious falls ( n = 7, 6) was 1.00 (0.87 to 1.16); while mean difference (95% CI) in rate of falls/1000 OBD ( n = 9, 8) was −0.20 (−1.03 to 0.64); and odds ratio for becoming a faller ( n = 5, 5) was 1.11 (0.91 to 1.35). Multiple meta‐regression analyses yielded results even more strongly indicating null effect, and consistently identified prospective registration as the most protective factor against studies reporting over‐optimistic results.
Conclusions
Routine, hospital‐wide use of mobilization alarms appears ineffective for the prevention of inpatient falls.