Alarms? Do they work?

[Sixtyseven]

We have new administration at my SNF (this is pretty much a yearly event) and one of their goals is to eliminate all alarms on residents - Tabs, bed and chair sensors. They claim that "studies show there is no difference in the rate of falls between facilities with alarms and those without alarms". They claim the alarms disturb the residents' sleep. It has been my experience that alarms save residents from falls every night (11-7). In my 19 years experience in LTC, probably not a night would go by without me personally answering an alarm and finding a resident either climbing or sliding out of bed, and my staff were very diligent in checking alarms and answering alarms. Already, in just about two months' time, we are experiencing more falls. But, the administration blames it on the staff, because they should have foreseen these falls on their rounds. Of course, the facility has cut staffing, too. I just feel that falls are often devastating to our residents, and that all efforts should be taken to prevent falls. Of course staff should be making rounds, but we all know that it takes only seconds for a resident to fall OOB, and the alarms sometimes gave us these precious seconds to prevent a disaster. Has anyone experienced the "no alarm" system? How did that work out?

[bethann27]

No experience with a "no alarm system" but have heard of others trying it with mixed results. Seems it would only be a part of what maintains safety. Would love to hear updates on how it works over time.

[wanderlustnurse88, RN]

We don't have alarms in our LTC. The rooms are just too far away to hear them from the nursing station. I like the bed alarms that are attached to the call bell system so it does not alarm in the pts room.

[CapeCodMermaid, RN]

My facility got rid of alarms almost 3 and a half years ago. The number of falls did not go up. Read the studies on alarm fatigue. Alarms also tend to agitate demented residents.

[Mandychelle79, ASN, RN]

I worked LTC and a geri psych unit where alarms were used. My mom has worked LTC for 35 yrs. We have the same opinion... more often than not the alarm just tells us that someone is already on the floor. For ever fall I prevented from happening about 7 more happened that they were just found on the floor.

[kbrn2002, ADN, RN]

When we went alarm free I was of the same mind as you OP, I thought the idea was insane! After experiencing it I have changed my mind. Alarms don't usually prevent falls, it is rare that a staff member is close enough to answer the alarm before the fall happens. At best the alarms just alerted us that somebody was already on the floor. The noise also startles the person wearing the alarm making a fall that much more likely. These elderly people with dementia can also be very smart! Figuring out how to turn off or disable the alarms is pretty common, one of our ladies with a tab alarm used to take the top of the toilet tank off and dump her alarm in there when she went to the bathroom without help. I still think she was the catalyst for our alarm free movement since she destroyed several and they are not cheap!

[Terse]

Sixtyseven: Possibly eight months ago one of our current RNACs proposed a "No Alarm" idea at a facility meeting. Our Director of Nursing expressed preliminary support for the idea. No policy has yet materialized.

My experience has been similar to yours. During a standard night shift sensor alarms will ring and patients unsafe to self-transfer try to do so or have shifted precariously in bed. This is particularly true among patients within three days post-admission. We (Nursing Assistants and I) consistently arrive "just in time" to keep the patient from self-injury.

Needless to say at first glance I feel the "No Alarm" policy warrants further consideration. The question is whether bed and chair alarms, possibly disruptive of sleep, peace of mind and patient dignity, perform a greater good by preventing falls, potential injury, and rehospitalization. I suspect that they do. We need evidence.

Over the next month (February 2015) I'll keep secret tally of how many patients are saved from evident risk of injury through alarm responses by my Nursing Assistants or me. To be fair, I will also track ringing alarms unrelated to patient safety.

Look for results in March.

[bethann27]

Sixtyseven: Possibly eight months ago one of our current RNACs proposed a "No Alarm" idea at a facility meeting. Our Director of Nursing expressed preliminary support for the idea. No policy has yet materialized.

My experience has been similar to yours. During a standard night shift sensor alarms will ring and patients unsafe to self-transfer try to do so or have shifted precariously in bed. This is particularly true among patients within three days post-admission. We (Nursing Assistants and I) consistently arrive "just in time" to keep the patient from self-injury.

Needless to say at first glance I feel the "No Alarm" policy warrants further consideration. The question is whether bed and chair alarms, possibly disruptive of sleep, peace of mind and patient dignity, perform a greater good by preventing falls, potential injury, and rehospitalization. I suspect that they do. We need evidence.

I work nights and find myself helping the patient more often than finding them on the floor. Building layout, staffing levels etc. play a huge roll I'm sure. BTW my facility is staffed very well ....each CNA has between 12- 14 on nights with each nurse covering two halls with a total of 21.