resident falls

Antikigirl, ASN, RN · Oct 11, 2005

My facility works with a variety of types (mostly because private pay folks must buy their own). Most are the chair alarms, but we also use bed and mat alarms.

We also use baby monitors...but this has always struck me the wrong way. You see, the monitor is in a resident room, then one in the hallway. Anyone can hear what is going on in that room, and I feel that is a LARGE breech of privacy! I know I would feel so volunerable if anyone can hear what goes on in my room...what if I had a bean burrito lunch...or started talking to myself...or someone hearing what a caregiver was doing with me ("okay we will be turning you over so we can wipe you...wow...you really had to go didn't you???") how embarresing!!!!!

I don't feel these really solve falls, but you do hear the alarms better...but at what cost to the resident (dignity, privacy, liberty, freedom)???

CapeCodMermaid, RN · Oct 11, 2005

We've never had any problem with the state and personal alarms. They are NOT considered restraints so I don't see the problem. We use what are like TABS alarms, seat alarms, bed alarms. All the companies seem pretty much the same. I want to buy some of the talking alarms but they are much more expensive so so far the answer has been no.

Julie frm Dallas · Oct 11, 2005

My LTC facility uses a bed alarm (a thin rectangular mat that is placed under the pts rear end while in bed). These are the biggest pain in the neck! They are ALWAYS going off for no reason, and they are loud enough to wake the dead in China. Many of the roommates complain of the noise, the alarms are just too sensitive to movement I believe. I prefer the clip-on personal alarms that can be transfered from w/c to bed.

Antikigirl, ASN, RN · Oct 11, 2005

I was going to mention that the mat style alarms are a pain! I have a resident that sits upright in her chair and they put the pad down...if she even MOVES a foot or chooses to cross her legs....it goes off! That upsets her very much...not to mention the poor caregiver that has to stop everything and run there every time! (it actually scares her out of her seat and then BOOM!)

I don't like the mat type! Sadly she was able to turn off or fool the seat and clip on ones at every turn!

boopchick · Oct 11, 2005

We use tab alarms, pressure alarms for bed and chair, and motion sensor alarms. :)

panurse101 · Oct 12, 2005

Thank you to those that replied. We are using basically the same kinds. The mat ones are terrible. With them constantly going off. The state told us to be careful with alarms, not to jump right to them. which is what our nurses were doing. Also, if a resident is always taking the alarm off then they shouldnt have it, we need to look at other interventions. Alot of facilities here in Pa, have gotten cited due to falls, and the facility relying on alarms.

Thank you all again.

trudyarn · Oct 21, 2005

Our unit has used enclosure beds for the past couple of years. Patients have freedom to move about in their bed, call lights, 02, and other equipment required to be used by the patient can remain in the bed with the patient. All 4 sides are zipped, and the mesh sides are easy for the patient to see out of, even when he/she wants to watch TV.

Most patients who have been ordered the enclosure bed have had a history or at the time of the order, have shown some way of harming himself/herself or others. These patients are usually hip/leg fx patients, demented patients, and patients who have no one (staff, family or friend) to stay one-on-one to observe him/her.

Patients' reactions to the enclosure bed vary. Many dementia patients are in different levels of confusion (crying, screaming, calm). My experience has been that the crying and calm patients accept the bed as a comfort zone. The screaming patients take a while longer to adjust.

Our main goal when a patient is restrained in the enclosure bed is to continue assess orientation, to educate the patient and family on criteria to d/c the bed. Once the patient is compliant with the criteria and has shown that he/she is safe from falling (or the cause of the bed being ordered in the first place) one side is left open while someone is in the room, progressed to one side open at all times (which ends the restraint order).

Posey vests are usually used while patients are in wheelchairs to prevent the patient from falling out of the wheelchair or self-ambulating. Wrist restraints are rarely used on our unit, unless the patient attempts to remove a Peg Tube or NG Tube or IV line.

Trudy RN

Baton Rouge

CapeCodMermaid, RN · Oct 21, 2005

We would NEVER be allowed to use that kind of bed in Massachusetts. We can't use posey vests at all, and if we used wrist restraints for any reason at all, the state would file an abuse case against us.

cantoo · Oct 22, 2005

In Florida, we also would never be allowed to use one of those beds. No way could we use wrist restraints or posey restraints. The protocol in our facility is for everyone to have a personal alarm for the first 72 hours after admit and then as needed. We mainly use personal alarms and motion censors. We tried the bed alarms for a while , but also ran into the problem of them alarming constantly and waking the dead. They also broke quite frequently. We have a falls meeting every morning after our management meeting where all the diciplines get together and decide the best coorifice of action for prevention for each resident that's at high risk. Anyone who has had a fall the day before is looked at by PT and/or OT for positioning, nursing for pain and incontinence, activities for boredom, ect. It's not perfect, but it helps.

dawnb70 · Jan 7, 2006

We've had a lot of luck with the seat belt alarms for those known to attempt to transfer themseleves out of the w/c. They're not considered a restraint, and will only sound if the resident undoes the clasp.