what can be done????

[marielina85]

What can be done for a resident that has a fall history yet is non-compliant with alarms and asking for assistance?????

[JulieCVICURN, BSN, RN]

I'm not sure what it is exactly that you're asking. I'm not surprised at the fall history if the resident is non-compliant with alarms. What sort of assistance are they asking for? How does the resident have a choice regarding the alarms?

[Ginger80]

I had a resident like that- refused siderails, bed sensors, instead of ringing for assistance, would try to get up on his own. This resident did not have dementia. Was stubborn and would on occasion fall. I would talk to him about it repeatedly, and DOCUMENT every time. 2 nights ago, he fell...and broke his femur.

We did everything we could do, even q 30 min. checks on nights, put 2 call bells within his reach, etc.

Sometimes there's only so much you can do. But chart it all.

[bbie17]

I'm confused...how can a patient refuse/be noncompliant with bed sensor?? Don't you just set the button on the bed? I set the bed alarm on all my patients who are at risk for fall and most of the time, they don't even know I've set the alarm.

[crissrn27, RN]

Some residents are tricky tricky! I'm not sure how this one LOL I used to have would turn her sensor off and pull her chair alarm off but she did it repeatedly. And fell repeatedly!

[itsmejuli]

Some residents are just a pain and there is nothing we can do about it.

We can talk and educate until we're blue in the face and they're still going to be non-compliant.

[gentlegiver, ASN, LPN, RN]

Residents may be old and not able to move well, but they still can figure out how to reach behind them, under the bed, onto the bedside stand, you name it to shut off the bed/chair alarms. Just keep charting that you are setting them and he/she is shutting them off. Also don't discount the "help" from room-mates who will shut them off for them (and themselves because they are tired of being woken up by the alarms going off).

[PatricksRNMommy]

If your patient is alert and oriented and able to make decisions for themselves, your best bet would just be to DOCUMENT DOCUMENT DOCUMENT. Document that you educated your patient about the factors that put them at risk for falls (medications, IV or O2 lines, illness, etc.), document that you encouraged them to call for assistance, document that you attempted to utilize your fall prevention protocol, and document your patient's refusal to comply. At my hospital, we have a refual of services form that patient's can sign to refuse medical procedures, blood transfusions, tests, and even things like bed alarms and putting the top 2 side rails up. Find out if you have a form like this and USE IT. When in doubt about what you should do, your charge nurse or the Risk Management department should be able to tell you what to do at your facility.

[marielina85]

.............................

[Muffy5]

So you say this resident doesn't have dementia? Sorry, if I missed that part. We had a resident who has dementia, but was able to remove her tabs alarms and had repeated falls with no injuries (thankfully). All we did was document, document and eventually it was enough to get an order for a Broda chair. There is still the time she is in bed, of course. Do you guys have any sensor alarms? I usually just part outside this resident's room with my med cart when I am taking care of her,so I can react promptly. She has padded side rails, floor mats and arm and leg protectors she must wear, in case she does fall. If you are attempting to intervene, just make sure you document it, so you have proof that you are doing everything in your capabilities. Good luck to you on this one, I know it is extremely frustrating!

[gentlegiver, ASN, LPN, RN]

Why in the name of AllNurses would your DON go after you for a pt's refusal to heed your warnings?? Can't say it enough!! Document, Document, Document!!!!!

[scoochy]

Have you used a motion sensor?