Indications for bed alarm use

[guest112]

I work in a med/surg unit and many of our patients are fall risks for various reasons. We use a fall risk scoring system per policy. But high risk for falls does not always indicate bed alarm use.

Has anyone heard of a bed alarm scoring system that would indicate bed alarm use? Some of the components I would think would be included are 1) High risk for falls per policies scoring system, 2) Unable/unwilling to use call light, e.g. confused, poor memory, poor cognition, 3) Reason to get out of bed, e.g. bladder urgency, hallucinations, previous attempt, and 4) Ability to get out of bed

Any comments would be helpful

[turnforthenurse, MSN, NP]

We use the Morse Fall Scale...and if there are any other reasons for me to think that this patient is an increased risk for falls that aren't established on the Morse Fall Scale (like the reasons you mentioned above), they are automatically getting a bed alarm. The floor I used to work on had built-in alarms on the beds.

[SoldierNurse22, BSN, RN]

I've seen a couple scales used for scoring that occasionally indicate that a patient is a candidate for bed alarm use.

"Compulsive", "not alert and oriented to self/place/time", "not oriented to own abilities and limitations" and "confused" are all indicators that I've used in combination to justify a bed alarm.

[nurseprnRN, BSN, RN]

I work in a med/surg unit and many of our patients are fall risks for various reasons. We use a fall risk scoring system per policy. But high risk for falls does not always indicate bed alarm use.

Has anyone heard of a bed alarm scoring system that would indicate bed alarm use? Some of the components I would think would be included are 1) High risk for falls per policies scoring system, 2) Unable/unwilling to use call light, e.g. confused, poor memory, poor cognition, 3) Reason to get out of bed, e.g. bladder urgency, hallucinations, previous attempt, and 4) Ability to get out of bed

Any comments would be helpful

Look at the general fall risk literature anyway, and use your nursing judgment. Things like polypharmacy, meds c sedating effect, postural hypotension, diuretics (urgency effect), any gait or balance disturbance...

[OlivetheRN, ADN, BSN, RN]

The facility I work at uses a fall risk scale, and our policy is that any patient who scores as being a high fall risk is to have the bed alarm on. Where we've run into problems is with patients who are alert and oriented, but because they've had a fall within the last six months and maybe they have a foley and are on lasix, they'll be a high fall risk, but will be adamant that they do not want the bed alarm on. Or we get the tiny little old ladies who just don't have enough body weight, so that when they turn over in bed it will a lot of times set off the bed alarm, and while they may be a high fall risk because of gait issues and the like, they are otherwise alert and oriented and aren't apt to jumping out of bed alone. In that case, because it's policy for all high fall risk patients to have their bed alarm on, we have to document that they refuse the bed alarm, and more recently, there's a form that they have to sign.

On the flip side, like GrnTea said, we use our judgement a lot to use the bed alarm for patients who are either low or moderate risk, but may be having confusion from a medication they've recently received, and may be more inclined to get up without assistance and be unsteady on their feet. In that case some nurses will go ahead and rescore them, others will simply put the bed alarm on while they're drowsy from the med.

[S.G.]

We use the Morse Fall Scale and anyone scoring high risk automatically gets a bed alarm activated. All Ortho surgeries as well by hospital policy, since they had our facilities highest fall rates, are required to have a bed alarm. High fall risk patients get a sign on their door, a brightly colored bracelet, and a yellow blanket on their bed as well. Outside of policy dictated high fall risk patients, it's a nursing judgement. We chart the fall score and, even if they score low, there's a spot to indicate nursing judgement for moderate or high risk.

Most of those nursing judgement reasons have already been mentioned. When I worked in the unit, I put any patient that was awake on a bed alarm because of all the lines and wires. There was a huge risk for tripping over them and pulling out lines causing trauma.

[fmxkrazyone]

We also use Morse scale, it is also our unit policy to put a bed alarm on every new admission for the first 24 hours regardless of their condition. The unit I work on is neurology and most pts are at a high risk. Some are with it but have just had brain surgery or spinal surgery and don't need to fall and hit their head trying to get to the bathroom, so most people on our unit get a bed alarm, it has helped prevent a lot of falls on our floor.

[guest112]

Thanks for all of your input!