person in hospital gown using walking frame beside hospital bed

It is not uncommon for me to hear from potential customers that bed and chair alarms do not prevent falls so we are choosing to eliminate them in our facility. After all, if these products do not prevent falls then why incur the additional expense?

It is a logical argument and one that I have heard mostly from Long Term Care facilities about the shortcomings of bed and chair alarms. Let’s examine this statement more closely: My initial reaction is: “what are you going to do differently to help prevent falls without help from these devices?”

The typical response is that facilities have updated their protocol to ensure that staff is “stopping by” more frequently for those who are at high risk of falls. Sounds good on paper but how practical is that to achieve?

If simply requiring your staff to spend more time with residents were that easy it should solve most of the challenges that Long Term Care facilities experience every day.

What is your ratio of staff to resident? Will it be sufficient to allow your staff to visit each resident more frequently? If so, then you are probably the exception rather than the rule.

In Wisconsin where I live, unemployment is at an all time low of 2.8%. It’s a great number if you’re with the State Chamber of Commerce but I almost never drive past a LTC facility without seeing a large banner sign in front of the building stating that they are now hiring CNA’s. Does your facility have enough nurses and CNA’s to be able to sufficiently visit high-risk residents to prevent them from falling? How often does someone need to visit a resident to achieve your goal? Is it every 30 minutes? Every 15 minutes? How is that being monitored? Is that achievable with your current staffing levels? Will your staff be able to do all the things they’re required to do and still visit high-risk residents every 15 minutes? Remember when we actually had “sitters” available to help?

My second reaction is that I have never seen a supplier suggest that if you use a bed and/or chair alarm, falls will be eliminated. It is simply a tool to help you know when someone is exiting a bed, chair or toilet. I would make a comparison to other diagnostic devices. For example:

When a woman has a mammogram it will not prevent cancer. The idea of course, is to detect cancer as early as possible so if there is a problem it can be treated more quickly and efficiently.

The same is true with alarms. While alarms will not be able to prevent falls by themselves, they will give the staff the most advanced notification possible. You will at least be aware that a resident has left their bed, chair or toilet and is at risk for a fall. Wouldn’t you like to have as much notice as possible in that situation so you can possibly prevent the fall from occurring?

Clearly nuisance alarms are problematic but here are 5 things you can do to alleviate the noise pollution of nuisance alarms:

  1. Utilize your nurse call system – When you incorporate your facility’s nurse call system you can turn the sound down or even off and still have the staff receive notification via phone, pager and/or nurse call lights. This will be especially helpful when more than one person is in a room so the alarm will not disturb the other resident but will still notify staff and allow intervention.
  2. Delay function – Adjust your alarms when necessary to delay notification for a couple seconds so they won’t alarm when a resident is fidgeting and momentarily off the sensor.
  3. Update your facility’s Risk Assessment Form – These products shouldn’t be used on every resident so by adjusting your scoring metrics, you can use these products exclusively on those residents who are at greater risk of falling. Contact us if you would like to use our Risk Assessment Form.
  4. Use Analytics – When you incorporate your nurse call system you should be able to get data that shows you when these alarms are most active. If you notice that between 1:30 and 2:30 resident “X” is frequently creating an alarm, perhaps you can change your protocol to be more visible at that time rather than every 15 minutes of an 8 hour shift.
  5. Staffing – I realize this is a big challenge for almost every facility bug without enough staff, these problems will inevitably worsen regardless of your method of preventing falls. How much time is the facility spending every week searching for he best staff possible for your facility? If you are waiting until 25% of your staff are pulling double-shifts, it’s probably too late. Facilities need to be strategic about finding new staff and the process should be ongoing and persistent.

In the end, facilities can and should do what they think is in the best interests of their facility and residents. Let’s be careful however not to throw out the baby with the bathwater. Falls are still a serious problem and the repercussions of a fall are well documented.

I have former “alarm-free” facilities as customers who experienced a fall when that resident had a litigious family member who did not appreciate that some available tools were not being used at the time. Expectations from the family members are that loved ones will be safe and secure in your facility. Falls are a serious challenge and require facilities to use everything in their disposal to limit them. To learn more about our Fall Management Solutions, that reduce Alarm Fatigue, please contact us at your convenience.

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