The facility I used to work in had the ankle bracelets, but they only made the alarms go off if the residents went out the MAIN door. If they went out the door on the unit a bell would sound, but only for the time that the door was actually open. Well, if everyone is busy doing patient care then whose job is it to drop what they are doing when the bell rings? Yeah, its everybody's responsibility, but everybody tends to figure somebody else will do it. Which means that as the only RN on the floor you had better go make sure nobody escaped every time the darn thing goes off because it will be YOUR head on the chopping block if somebody gets out.
Had one particular patient who was very restless. She would go out the door 50 times a night sometimes. One door led to the courtyard, and she would go out that, through the courtyard, and then back in the other door. That led to complacency among the staff because they would figure she was just doing the courtyard thing when they heard the bell. But usually we were able to call her back before she actually got all the way out the door. One time she somehow actually made it. I got a call from the business down the street where she came to the door. Thank God nothing bad happened to her.