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Within the acute care hospital setting, falls and fall prevention are a common concern among clinical staff as significant time and resources are dedicated to fall prevention. Chair alarm systems are commonly used; however, they can increase costs and may also contribute to alarm fatigue via overly sensitive systems.To compare the reliability and accuracy of an installed chair alarm system with a timer (developed by the principal investigator), titled Safe Sitting System, as compared with 2 commercially available and commonly used products: (1) a single-patient use pressure-sensing alarm system (primary control) and (2) a magnetic clip-on alarm (secondary control).Single-center double-blind randomized controlled trial using a within-subject design.Seventy-five healthy volunteers 19 to 60 years of age.Blinded subjects performed a series of 9 common motions in 2 chairs—one that contained the primary control product and the second with the Safe Sitting System. Which chair was tested first was randomized and a magnetic clip-on alarm was used in both trials. A blinded data collector recorded whether either alarm was activated or not during each motion.The Safe Sitting System chair had a total of 16 false positives out of all 600 responses (2.7%) and 0 false negatives out of 75 responses. The primary control product had a total of 187 false positives out of all 600 responses (31.2%) and 6 false negatives out of 75 responses (8.0%). The number of appropriate responses between the chairs was determined to be statistically significantly different as assessed by a sign test (P < .0001).An installed chair alarm with a timer and a slight delay in alarm response significantly reduced false positives and false negatives, which has the potential to reduce falls and improve patient safety during hospitalization. In addition, there is the potential for cost savings from an installed chair alarm system as compared with a single-patient use chair alarm.