In a surprising report out of Connecticut, one nursing home has made the decision to purposely remove all the alarms from their facility. That means the alarms on patients’ beds, the alarms on wheelchairs and even the alarms on patients themselves have all been eliminated. Though this may seem to increase the risk of serious accidents occurring, quite the opposite has happened according to the director of nursing. Rather than compromise care, the number of injuries has actually fallen, and by quite a lot.
The director of nursing at the Connecticut facility first got the idea several years ago and debated making the move for a number of months. Once she decided to dive in, she found that the hardest problem to overcome was the staff. The employees at the nursing home feared that by removing alarms they would subject themselves to liability in the case that a resident fell and was injured or that more residents could get hurt with no system in place to alert the staff members on duty.
The director spent more than a year slowly easing her staff into the new routine and the results have been amazing. Not only have the reports of injuries fallen noticeably, but the staff and patients are both feeling the change in terms of a reduction in stress. The elimination of the constant beeping and buzzing lowers tension among staff members and also helps ease anxiety among the patients.
The Connecticut nursing home is one of several places across the country that have begun experimenting with the idea of going “alarm-free.” The move was prompted after doubts were raised about the effectiveness of all the beeping. Rather than rely on the alarms that warn when a patient tries to get up or move around, staff members are trained to spend more time observing and walking around, without the distraction of the alarms.
One study has been done on the subject which was published last year in the Annals of Internal Medicine. The researchers found that alarms at a hospital in Tennessee had done nothing to reduce the fall rates of patients. The study concluded that the alarms can actually lead to more falls because the noise can disrupt patients’ sleep which then makes them more tired and prone to falling.
Another study done in Massachusetts found that after one facility removed its alarms the patient injury rate declined by 32 percent. Another facility recorded a 15 percent decline in falls. Experts say that when staff does not have the alarms to act as a crutch, they are forced to take a more active and involved approach towards patient care.
However, this news does not mean that all nursing home should begin ripping the alarms out of their beds. For this to work other changes need to be made. For example, frequent rounding by staff needs to happen, especially focusing on those patients at risk of falling. Even more importantly, nursing homes that are interested in going “alarm-free” have to change their way of working, moving from a reactive to a more proactive approach.
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Source: “State Nursing Homes Pilot Alarm-Free Initiative – Carefully,” by Lisa Chedekel, published at Courant.com.