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no more alarms for fall risks!

CNA/MA   (4,594 Views | 13 Replies)

Missingyou has 20 years experience as a CNA and specializes in Long term care.

7,424 Profile Views; 692 Posts

Today at our staff meeting we were informed that the "new trend" in nursing homes is going towards getting rid of all bed & chair alarms for those who are at risk for a fall. :nailbiting:

The reasoning behind it is that it wakes other residents during the night and during the day they have the right to be free from restriction. We as "care providers" which includes not only CNA's but nurses and housekeeping, and EVERYONE employed by the facility will be responsible for keeping a constant eye on those residents at risk of falling.

Our facility already requires all employees to respond to a chair/bed alarm. But if the resident is in their own room/in bed, how are we to have a constant eye on them because they no longer have an alarm? What of the dining room where there are 50 residents and 5 staff all of whom are feeding at least one resident?

I see alot more broken hips and black eyes in the future for these residents! :sour:

Your thoughts??

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anh06005 has 6 years experience as a MSN, APRN, NP and specializes in Cardiac, Home Health, Primary Care.

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Sounds scary to me!!! Seems like when they're in bed they should AT LEAST have some sort of "silent alarm" that notifies the nurse's station! Wonder when the last time the people who made this decision worked the floor??

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amoLucia specializes in LTC.

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We all know that alarms actually do not stop the falls - only allows us to hear pts getting up. The task is then to get to them fast enough that we can catch them before they wobble & hit the floor.

It'll be a major disconnect for staff to function without alarms when they've been around so long.

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327 Posts; 4,365 Profile Views

Years ago when I worked at a SNF they did away with all alarms and the fall rate decreased and stayed down. It can work.

Instead of using a chair alarm/bed alarm for a fall risk patient we used interventions like a low bed, mats on the floor, wheelchair locks, frequent safety checks, a room near the nurses station, etc. we would individualize care plans based on individual needs. One dementia patient had fallen several times out of the right side of bed, turned out he slept on a bed up against the wall on the right side for his adult life. We made a care plan to move his bed against the wall like it was at home and he never fell again. Other patients always tried to get up at about the same time every night, did they need to go to the bathroom? Were they hungry? What could we do differently to help them safely? Maybe schedule toileting at 2100 for the patient that tries to get up around 2200-2300 every night. Or offer a snack/ or leave a snack at the bedside table to the patient with the munchies every night. Some patients fall at shift change, is it the noise that gets them curious? Or maybe this is the time they used to get ready for work. What can you do to prevent them from falling?

Edited by Loo17

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Missingyou has 20 years experience as a CNA and specializes in Long term care.

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Our facility has already been doing the care plans that Loo17 mentions. It hasn't stopped the resident's during the day from getting up or self transferring during the day. We have almost always been able to "catch" them before a fall but, only because we heard an alarm.

Our bigggest struggle is some of our residents are simply bored. Sitting in their rooms or too restless to participate in the music or whatever. They always refuse to attend activity.

Sitting in the hallway is not something they choose to do and it would mean INSISTING they do & closing off their room, which we all know is not an option and against their rights.

I think if there were more activities that were tailored to each residents preference it may work, but that would take more staff and more time than I believe any nursing home would be willing to do.

This whole idea really scares me and if they put that kind of responsibility on CNAs who already have so much to juggle without adding even a few more staff, I don't think I will continue working in LTC.

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318 Posts; 4,645 Profile Views

I've heard rumors of this in my state; state inspectors in my state say they are a form of restraint but I think that's pushing it. Going without can work, but there are also other systems that aren't as noisy. In our hospital, we use RN alarms. The box in the patient's room isn't loud and the centrally located roster and indicator tell you which number is sounding.

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Red Kryptonite has 3 years experience and specializes in hospice.

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We as "care providers" which includes not only CNA's but nurses and housekeeping, and EVERYONE employed by the facility will be responsible for keeping a constant eye on those residents at risk of falling.

Ha. Haha. HAHAHAHA......

Yeah right. The onus will be on the CNAs who already have insane ratios, and it will be just one more thing to write them up for.

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118 Posts; 4,054 Profile Views

We are going through this at my facility as we speak. The goal is to be alarm free by the new year. They have started taking away alarms from the ones who are less of a risk. Now we have residents getting up and self transferring because we have no warning. I've worked with one woman for over 3.5 years and in that time she hasn't fallen once. Welp, guess who fell 2 weeks ago? Wonder how long she was on the floor before rounds were done and she was found? What we are being told, is that State knows and expects falls to increase...BUT, the facility will be fined less for those falls. And yes I am being serious. So I guess it doesn't matter that we are going to have a ton more falls, just as long as it costs the facility less. We are constantly running short, there is no way in hell we will be able to keep an eye on everyone. We *run* for alarms multiple times a shift, and have prevented many a fall because of it. Now I guess we'll just call the nurse to come asses everyone before we scoop them off the floor again.

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Red Kryptonite has 3 years experience and specializes in hospice.

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We *run* for alarms multiple times a shift, and have prevented many a fall because of it. Now I guess we'll just call the nurse to come asses everyone before we scoop them off the floor again.

My experience is similar. I'd love to know where they do the studies that show lower fall rates when alarms are taken away because my day to day work life just doesn't support that at all.

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Missingyou has 20 years experience as a CNA and specializes in Long term care.

692 Posts; 7,424 Profile Views

They recently removed alarms from at least 4 resident's on our floor.

Within 2 weeks, 2 of those resident's fell. One broke his hip and is currently in the hospital. He was in his room and we only knew he fell because he was screaming in pain! ...the other fell in the diningroom and although he didn't break anything, he has a bunch of skin tears and a badly bruised arm. :down:

So far no CNA's were written up for these incidents (including the one in the diningroom where there were 5 CNA's who were present and feeding other resident's). By the time we realized he was up and moving, it was too late to reach him.

This "no alarms" isn't going so well. I wonder how many times they have to fall before they figure out "WHY they are getting up in the first place" and can adjust the plan of care to address it.??

This whole thing really frustrates me.

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fibroblast has 5 years experience.

486 Posts; 9,899 Profile Views

Only pts/residents that truly need an alarm should have an alarm. If a cna has 14 patients and 6 of them have alarms that constantly go off, there is no time to do all the work. She is spending time answering alarms and not getting the work done.

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