|ADvancing Care Newsletter|
|Past Issues | Download PDF||November/December 2012|
However, just as restraints cause harm by keeping people from moving, so do personal alarms. There is also no evidence to support alarms’ usefulness in preventing falls or injuries. In fact, in most cases, falls continue to occur. From a practical perspective, many residents dislike them and repeatedly hide or remove them, devices malfunction (the cord breaks or detaches, batteries die, alarms fail to go off or are slow to respond), and if too many are in use, the warning sound loses its effectiveness at alerting staff.
For residents, there can be numerous negative consequences to their quality of life and mobility:
One of the reasons alarms don’t work is that they are reactive rather than proactive, because they only indicate to staff that the resident has moved, or has already fallen. Further, CNAs responding to alarms are often distracted from other important duties, including ADL care and communication with residents. Without a doubt, there are many people in nursing homes who are at risk for falls and injury and who need to have a safety plan in place. However, these plans need to be highly individualized and based on a thorough assessment of the risk factors that exist for the person and her/his clinical condition, in the physical environment and also the organizational environment. The alarms provide a clear example of an intervention that, by attempting to prevent the risk of falling, may actually increase the risk of serious injury from falling. They give a false sense of security and at the same time, absorb an inordinate amount of staff time responding to the alarm.
Increasingly, nursing homes are eliminating the use of these alarms. Isabella Geriatric Center in northern Manhattan did so about three years ago, resulting in a reduction of the incidence of falls. They first eliminated the use of bed and chair alarms in 2009, and have maintained the reduction in falls all this time. They developed a careful plan to accomplish this, which involved assessing the needs of each individual resident. In the Bronx, Morningside House was also successful in eliminating the use of bed and chair alarms. The Jewish Rehabilitation Center for the North Shore in Massachusetts also recently eliminated the use of alarms, and they too discovered that they were able to reduce falls at the same time. The step-by-step approach they took to eliminating alarms is described in a Case Study published by the Massachusetts Peer Review Organization (MASSPRO, see link at left). As all of these facilities would agree, in most cases, the best way to prevent the risk of falls with injury is to promote residents’ balance, endurance, and overall mobility resulting in a reduction in the incidence cap.
Adapted with permission from “Rethinking the Use of Position Change Alarms” by Joanne Rader, Barbara Frank and Cathie Brady.
|Our thanks to the Herman Goldman Foundation for their generous support of this newsletter.|
|Visit the ADvancing Care™ Homepage for past issues.|
|Resources & Events|
“Rethinking the Use of Position Change Alarms”
Case Study, “Reducing Falls by Eliminating Resident Alarms at the Jewish Rehabilitation Center for the North Shore.”