離床報知機對預防住院病人跌倒之成效不一，本研究目的為評估離床報知機是否可有效偵測病人離床，及是否減少住院老人跌倒異常事件的發生。本研究為兩組前瞻式追蹤觀察型設計，計算離床報知機偵測病人離床之敏感性及特異性，與比較離床報知機使用前後各半年跌倒發生率之差異。第一部份共收集175 位符合適應症、使用離床報知機病人之機器警示資料，由護理人員每日工作中以記錄表收集資料，在台北某醫學中心4個病房收案。第二部份則先收集未正確使用離床報知機時病人是否跌倒之資料，再收集正確使用離床報知機時病人是否跌倒之資料。資料分析：離床報知機準確度採用Diagnostic test分析；病人屬性與是否跌倒，使用X^2 test與相關危險度檢定。主要結果：一、離床報知機之敏感性為94.4%、特異性為73.5%，陽性預測值為68.9%，陰性預測值為95.4%，而相似比為3.56；二、未依照離床報知機作業標準，跌倒發生率0.166%；依照離床報知機制訂標準作業流程執行，跌倒發生率0.126%；三、離床報知機適用族群稽核監測遵從率為81.4%，正確性監測為97.3%；四、使用離床報知機能降低17.2%跌倒發生風險。本研究搜尋國內外研究相關文獻，製作離床報知機標準作業規範，藉由修訂住院病人預防跌倒執行對策、並善用離床報知機，期望降低住院老人跌倒發生率、跌倒傷害率，降低醫療成本，確保病人獲得完善的照護。

Most falls in acute care settings occur in the rooms of patients, especially during attempts to get in or out of bed. Bed-exit alarms were designed to detect patients moving out of their beds, thereby increasing staff surveillance of cognitively and/or physically impaired patients at risk for bed-related falls. However, the overall reliability of bed-exit alarms in detecting patient movements out of bed has not been clearly established. The purpose of this study is to develop an evidencebased bed-exit alarm care guideline for patients in acute care settings and to provide comprehensive strategic care plans for fall prevention among these patients. This research was conducted through a two-group, 6-month cohort perspective study to investigate the effectiveness of bed-exit alarms in preventing falls among patients in acute care settings. The relative ratio of falls, injury-related falls and fall rates in the two groups were computed and analyzed. The accuracy of the bed-exit alarms was calculated. The main findings were as follows: (1) the sensitivity, specificity, and likelihood ratio of the bed-exit alarm were 94.4%, 73.5%, and 3.56, respectively, for detecting when high fallrisk patients exited their beds; (2) the fall rate of the regularly performed bed-exit alarm cohort group was 0.126% and the fall rate of the nonregularly performed bed-exit alarm cohort group was 0.166%; (3) the adherence rate of nurses for performing the evidence-based bed-exit alarms care guideline was 81.4%; (4) the absolute risk reduction from using the bed-exit alarm was 17.2%. The result of this study is to develop a bed-exit alarm care guideline for patients and to implement an intervention to judge appropriateness in applying a bed-exit alarm system. Furthermore, it is recommended to expand this bed-exit alarm care guideline to other institutions.