Phasing out alarms?!?

  1. At a recent employee meeting, I learned that my facility is going to start phasing out personal alarms for residents. (chair & bed alarms, TEDS, etc.) The powers that be want to head off the new regulations that are being passed in my U.S. state that will prevent the use off alarms as a "dignity issue." I can't IMAGINE the number of patients who will be injured from falls if we don't hear the alert of an alarm, warning us that the resident may be in danger! I feel this action has the potential to cause serious injury to the patients; many are suffering from dementia and are unaware that they cannot rise or walk without assistance. From past experience, all I can see resulting from this is an unending parade of fractures, brain injuries, and more..! I am seriously considering finding employment in another facility that makes patient safety a higher priority.
    Is this happening all over the globe, just in the U.S, or only in my state?
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  2. 26 Comments

  3. by   Nascar nurse
    I can't really tell how long you have been in LTC. I have been around...well that doesn't matter

    I was around when the big thing was restraint reduction. We all knew they would just kill themselves if we didn't tie them down but they didn't

    I was around when full siderails became taboo. We all knew they would just kill themselves if we didn't put those full siderails up every night, but they didn't.

    My facility has already gotten away from about 90% of the alarms we used to have. We all knew they would just kill themselves if we didn't get to them in time, but they didn't.

    I can only wonder what is coming next and only hope everyone continues to live through it.

    Ultimately, the alarms were the least scary for me (and that may be because they were actually the least restrictive of the other devices). I never really did believe the alarms prevented falls. I do believe alarms startle residents and those beginning to get up jump when that loud shrieking noise starts - now that causes falls because it scares them. I also believe that so many of them go off needlessly that staff quickly become immune to the noise and don't "run" to them as they did when it was a new and shiny intervention.
  4. by   VivaLasViejas
    The alarms really only warn us that residents are already up and moving.......they don't do a thing to keep 'em off the floor.

    I concur with Nascar nurse on this one. Alarms are a noise issue, and certainly a dignity issue (although how dignified it is to be found on the floor with a broken hip, I'm not sure). They're a 'feel-good' measure that makes us feel like we're doing something to protect residents, but they don't prevent falls. You'll get used to not having them pretty quickly......then you'll wonder how on earth everybody put up with them for so long.
  5. by   PsychNurseWannaBe
    I got rid of a lot of alarms on my units. When an alarm sounds and the resident sits back down or a staff members says, Mrs. Johnson you need to sit back down.... you just restrained them. As stupid as it sounds... they have a right to fall. Not to mention, alarms do not prevent falls, they only alert staff to a potentially unsafe behavior which equates to staff convience. Instead of alarming, why not 15 minute checks, or have therapy screen, have them do a walk to dine program, or whatever the root cause of it is. Maybe a 3 day bowel and bladder to establish a toileting plan, or a sleep study to see if they are getting the sleep they need and are not weak, initatiate a falling stars program. Review their psychotropic meds, do orthostatic BP for several shifts... it goes on and on. We just need to think outside of the box. Will resident's fall... yes. But slapping an alarm on never got you down to the root cause of the fall. It takes a lot of work to get out of that mind set about alarms. I had to do TONS of staff education because my CNAs were in an uproar. But, they adjusted. My unit is far quieter and families are liking it and so are the residents.
  6. by   morte
    i am much fonder of the sort that is plugged into the nurse call, and doesnt have to sound in the patients room....
  7. by   al586
    Thank you all for your responses! I feel a bit better toward the alarm issue now. I truly appreciate your time!
  8. by   CompleteUnknown
    Quote from morte
    i am much fonder of the sort that is plugged into the nurse call, and doesnt have to sound in the patients room....
    I'm not in the US, but these are the only ones I've ever seen, I can't imagine the noise and disruption of alarms that sound in the room. We only have the sensor mat type of alarm - they work through the nurse call system, and they are only used once we've assessed every possible cause for the fall and put plans into place to address anything that might be contributing. They don't prevent falls of course, but they do alert staff to the fact that a resident who isn't safe mobilising without assistance and doesn't remember to wait for staff is up and needs help to go to the toilet or whatever.

    I totally agree that if a loud noise sounds when a resident goes to get up, or if they are told to sit down or are put back in bed every time they try to get up, that's a huge dignity issue.
  9. by   muffylpn
    Quote from al586
    At a recent employee meeting, I learned that my facility is going to start phasing out personal alarms for residents. (chair & bed alarms, TEDS, etc.) The powers that be want to head off the new regulations that are being passed in my U.S. state that will prevent the use off alarms as a "dignity issue." I can't IMAGINE the number of patients who will be injured from falls if we don't hear the alert of an alarm, warning us that the resident may be in danger! I feel this action has the potential to cause serious injury to the patients; many are suffering from dementia and are unaware that they cannot rise or walk without assistance. From past experience, all I can see resulting from this is an unending parade of fractures, brain injuries, and more..! I am seriously considering finding employment in another facility that makes patient safety a higher priority.
    Is this happening all over the globe, just in the U.S, or only in my state?

    I would like to know which state you are in? Just last night on our GMPU. A Pt's family memeber told us and I quote " I'm the HCP and if my mother falls I'm going to sue this hospital" So she was placed on a 1:1 only for our nurse manager to come in the next day and say " We don't but people on 1:1 for being a fall risk" ( well we do, but whatever). I love our bed alarms and I hate incident reports and treads to be sued. Confused people have rights and I don't think alarms have anything to do with "dignity". I personally enjoy knowing that my very confused Pt who likes the get up and urinate whatever he likes ( cause he thinks he's in the BR) does not AGAIN pee on his rm mate. What about his dignity?
  10. by   lamazeteacher
    The wise way to implement change, is when a (recognized as sufficient)study proves it is prudent.When the inevitable lawsuit occurs, that protects the facility and reassures families that the change didn't occur due to a whim or budgetary reason.
  11. by   Vinniesguy
    We had these excellent sensor mats that when the residnet stood up out of their wheelchair this loud and authoritative voice said "Sit down!"
    The resident would look slightly bewidered but sat down all the same!

    On the ward I'm on now the call bell comes through to pagers all the nurses wear so there's no loud noises anywhere - the only issue there is because the pt doesn't hear a bell go off anywhere they sit pressing the button thinking it doesn't work!
  12. by   Chaya
    Mixed feelings on this one. To my thinking, safety concerns beats dignity every time except in very extenuating circumstances. I do realize that frequently the audible alarm means "pt on floor". However, in a significant number of them you do find your confused patient wandering in time to bring them to the bathroom of whatever and prevent a fall. Or you are just in time to see your forgetful patient sit back down and say"Oh yes; I'd forgotten I"m supposed to call you to help me walk into the bathroom".
  13. by   NurseyPam
    Quote from al586
    At a recent employee meeting, I learned that my facility is going to start phasing out personal alarms for residents. (chair & bed alarms, TEDS, etc.) The powers that be want to head off the new regulations that are being passed in my U.S. state that will prevent the use off alarms as a "dignity issue." I can't IMAGINE the number of patients who will be injured from falls if we don't hear the alert of an alarm, warning us that the resident may be in danger! I feel this action has the potential to cause serious injury to the patients; many are suffering from dementia and are unaware that they cannot rise or walk without assistance. From past experience, all I can see resulting from this is an unending parade of fractures, brain injuries, and more..! I am seriously considering finding employment in another facility that makes patient safety a higher priority.
    Is this happening all over the globe, just in the U.S, or only in my state?
    I too heard this. I work in an acute hospital setting in the Midwest, and was told that we would begin phasing the alarms out. Very scary thought, as our nurses cover both the ER and Med-Surg unit, and out population is mostly elderly. Would be interesting to see if the "powers that be" who make the rules and regulations had a loved one fall due to NOT having an alarm system in place. It might make them change their minds!
  14. by   billyboblewis
    I have worked in different areas of the country and found that in some people believe that they should be able to move about as they choose unencumbered by devices of any type..life liberty and the pursuit of happines... The patients who are capable sign releases and sometimes families are involved. They do this despite the fact that it may cause them an early demise. I can actually state that one of my patients died after a nite time fall on a tile floor. His family was not upset about this happening knowing that he lived his life to the maximum. Perhaps this is a choice that is right for some people.

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