Reducing Alarms

kjwestm6 · Mar 14, 2012

Alarms are your friend! They are one of the best ways to keep residents safe and your workload reduced, They are not resraints and the provide everyone with a better peace of mind in the LTC. Now the use should be assessed often. A resident may improve or decline so that they do nit need some or any alarm. Alot of this can be evaluated when you compare MDS, ADL monitoring and Care plans.

noc4senuf · Mar 14, 2012

I am actually in the process of getting rid of all alarms in the building. THe only thing they do is alert staff that the resident is alreayd moving. If there is an issue with a particular resident, then they need to be observed more often. Enlist other depts and all staff need to get onboard to walk through the halls and units, ask reisdents how they are doing. Resident-centered care and a homelike place to live does not include the sound of alarms going off. More and more facilities are finding more creative ways to ensure safety. Yes, alarms are a restraint if the resident does not move for fear of the sound.

CapeCodMermaid, RN · Mar 14, 2012

Alarms do not prevent falls. They offer a false sense of security to the staff. Do a study for a few days. If Mr. Johnson's alarm is always going off after meals, send someone into to his room BEFORE the alarm sounds. I've found that many times the alarms do nothing but make the resident upset or agitated or downright MAD!

GitanoRN, BSN, MSN, RN · Mar 14, 2012

unquestionably, i tend to agree with most of the statements so far. however, alarms are useful in ltc when a resident or pt. if you will, has opened an exit door! having said that, staff should be making rounds more often to minimized this issue and all of the concerns above mentioned.

mazy · Mar 14, 2012

I have gone from thinking that alarms were an important safety factor to thinking that the only purpose of alarms is for us to be able to document that the patient has an alarm if they fall.

Alarms don't prevent falls. And they tend to go off unexpectedly, sending staff racing in all directions to find a ringing alarm on the bed of a patient who is eating comfortably in the dining room with supervision; or they don't go off at all, or someone forgets to place one, or the patient figures out how to disable it, or you find the patient on the floor holding onto the alarm.

It also causes some patients to become very agitated, which increases the risk that they'll fall.

We need to come up with something better, more staff to supervise would be nice, but I don't see that happening anytime soon.

genfree · Mar 15, 2012

We recently did away with our alarms. Alarms do not prevent falls, and eventually staff become so use to people accidentally setting them off that they do no react to the alams like they should. With each fall you should be looking at the possible cause of the fall and then care plan for an intervention to correct, such as was the fall because of a UTI, needing to use the restroom,or type of foot wear. The people who were the "frequent fallers" we placed first on 30 minute visual checks, then as they showed that there were no increase in falls or say no falls over 30 days we DC'd the 30 minute checks. Those that did fall we placed on 15 visual minute check which aren't many. Right now our facility has approx 60 residents and we only have 5 people on 15 minute checks. Also, on new admissions we do 15 minute visual checks for 24hrs. Also along with the 15 minute checks we started prompted toileting, we changed from the normal toilet from every 2-3hrs to person centered. After completion of the 3 day voiding records you look to see when the resident toilets or is wet, the best way is to show you an example. Example: Prompt to toilet between 0600-0700, 0900-1000, 1100-1200, 1300-1400, 1500-1600,1800-1900,2000-2100 @ noc if awake between 2400-0100 and 0300-0500. This is just what we do for you to use as ideas.

withasmilelpn · Mar 21, 2012

Our alarms page us and tell us who is setting it off - our pagers are also set to vibrate. I have worked where staff ignored them - those staff weren't the most caring frankly. In our facility that is not the case. Everyone reacts, unit secretary on. And to say they don't prevent falls... Baloney! I caught my Resident just before she hit the floor - she pitched forward and I was able to get her in time because of the alarm telling me she was standing. And she was on a toileting schedule and 15 minute checks as well. She went in between checks and before her 'typical' schedule. Because we monitor that too.I know that it is considered a restraint because too often we tell people just to sit down. Then they lose mobility, independence... In our facility we respond in order to help our Resident. We use it as a call bell - to find out what the Resident needs. If they want to walk, we walk with them. If they need to be toileted, we toilet them. Or hungry, or bored... You get the idea. These residents are cognitively impaired and not capable of making safe decisions or unable to communicate their needs. The alarms help us assist them and keep them safe. I find this new attitude of chair alarms being a restraint and not 'home like' frustrating and simplistic. I've cared for Resident's whose falls cause them to break a hip and never walk again or even die. Luckily never when I was working - when it happens because of this 'stupid' in my opinion - movement - I'll leave my beloved Residents and never look back.

noc4senuf · Mar 21, 2012

I've been in LTC since the 70's. we never had alarms and actually had less falls. I still believe they are more of a problem than help.

withasmilelpn · Mar 21, 2012

I don't see how that's possible. I've been at this for 21 years now (6 as an aide) and I find them helpful. Every time I catch a Resident - I've prevented real harm. It promotes independence - have you ever seen Residents lined up at the nurse's station and told they can't go back to their room? What kind of life is that? With a chair alarm, impulsive Residents that simply don't remember to call for help can let staff know they need assistance. They never should be used for convenience - I really dislike it when staff say 'sit down,' instead of determining the needs of the Resident. It is an absolute mystery to me that we have no problem protecting our small children with gaits, locks, monitors, etc - and understand that they require constant supervision. Daycares have ratios that support staff in keeping their charges safe. LTC does not have those ratios. We need help in protecting our patients. And please don't misunderstand me when I compare my geriatric patients with children. They are not, and should never be treated as children. However, CVAs, and dementia can take a person's judgement and abilities away from them. They will attempt to do things that they are not able to do - and will likely come to more harm than a child would with their fragile skin and bones. If we really want to go without then we need to seriously increase staffing.

noc4senuf · Mar 22, 2012

The first thing I noticed was just what you didn't want anyone to, the comparison of our adults to children. They are not children! Most lived full and productive lives. They also did not have all these alarms in their homes. Whatever facility they have chosen to live in now, is also their "home". they residen there, therefore they are residents. Patients are found in a hospital.

withasmilelpn · Mar 22, 2012

Please don't think that I think for one minute that they are children. We recognize that are children are vulnerable - and we staff accordingly. We don't value the elderly which is why we don't staff based on how vulnerable they are. And in my opinion - they are more vulnerable than children. Children fall and get back up, heal quicker and have healthy bodies to begin with. If you worked with me at all you would know I never treat my Residents like children. I respect their experience and lives.And I guess you missed the fact that our chair alarms ring to pagers that are set on vibrate. I attended a funeral years ago for a man that died from a hematoma when he fell. His wife lived with us too. They had no children - they only had each other. It was hard on everyone losing him then helping the wife cope. I think of this every time I catch a resident or get there in time to assist them. It's silly to say they don't prevent falls when I personally have stopped them because I was alerted by a chair alarm. I think this is why long term care is so frustrating now. I feel like it's harder and harder for me to do a good job. And never mind what we are going to say to the family or even the lawyers when something happens. There is technology available but we aren't going to use it because it's 'not homelike' phooey