Bed Alarms Reduce Falls

On the uses of bed alarms

Used and supported appropriately, they reduce falls and offer other advantages, as one facility discovered

When Charles Hise purchased Dunn Nursing Home in Selma, Alabama, in 1992—later relocated and renamed Park Place Nursing and Rehabilitation Center—there had been a recurring falls problem. Despite a 65% use of restraints, residents still were falling. Dunn Nursing Home had a 32% average fall rate in a population of 93 residents. However, because a patient may already have been on the floor when discovered, it was difficult to determine if an incident was an actual fall or a self-induced effort to lie on the floor.

After the alarm system was installed, the average fall rate at our facility declined from 32% to 6%, and has remained at that level for the past eight years. Interestingly, 90% of the remaining occurrences now involve chairs, not beds. Because people move around more in chairs, false alarms can be a problem as residents shift their weight on the sensor. To help prevent this, the chair alarm units feature delays of three or five seconds that can be set for active residents.

At Park Place, the alarm system has been adapted to various purposes. First, it is used as a planning tool. Coupled with initial and ongoing assessments, alarms inform staff about residents’ habits. For example, one person may consistently attempt to arise at a certain hour to go to the bathroom, while another may get up at nonspecific times, driven simply by an urge to wander. As a result of such “history,” nurses can adjust attention and care to each individual’s habits.

Second, it serves as an ultimate safety mechanism. The odds of survival are enhanced when nurses are alerted that a resident is attempting to arise from a bed or chair. If it weren’t for the alarm, the resident may already be on the floor for some period of time before anyone knows it. With the alarm, staff can know about a pending incident before a resident reaches the floor.

System Support
Staff training and accountability are vital to the successful application of an alarm system. Valarie Maxwell, LPN, head of Park Place’s training and quality assurance, conducts one-on-one orientation with new employees using a video, demonstrations, and verbal instruction on appropriate use. She also conducts periodic meetings with nurses and assistants to evaluate ways to improve procedures, and is responsible for explaining to families the alarm’s purpose and resident benefits.

Nurse supervisors check the system on a scheduled basis to ensure that it functions properly and that sensing devices are positioned correctly on beds and chairs. Sensing units are tested to verify they will send an alarm if a patient arises.