Elimination of Position-Change Alarms in an Alzheimer’s and Dementia Long-Term Care Facility

Abstract

In a long-term care facility, whose residents have been diagnosed with Alzheimer's disease or dementia, falls are a particularly prominent issue. Technology in health care has continued to evolve and play a larger role in how we care for our patients, even in preventing falls. However, overreliance on these types of technologies may have detrimental effects. In our facility, it was felt that staff reliance on position-change alarms was inappropriate due to the high rate of false alarms associated with these devices. We took a tiered approach to removing position-change alarms from our facility, monitoring the fall incidence rate for a period before, during, and after the elimination of these alarms. After discontinuing their use, we found a decrease in the rate of falls, and a decrease in the percentage of our residents who fell. Staff has easily adapted and reports a calmer, more pleasant environment.

Alarming and/or Alerting Device Effectiveness in Reducing Falls in Long-Term Care (LTC) Facilities? A Systematic Review

“…Improvements in type and the implementation of new alarm systems require sufficient staff training [19]. The appropriate use of alarms on the appropriate population of residents in the long-term care facility must be considered if alarms are to be fully leveraged [7,11,12,16,18,22,23,24,25,26,27,28,29,30]. Alarm maintenance is critical, and alarms must be one part of a more comprehensive plan of care to be most effective in preventing falls [18,24,25].…”

“…Alarm maintenance is critical, and alarms must be one part of a more comprehensive plan of care to be most effective in preventing falls [18,24,25]. Alarms have proven effective with the elderly population at risk of falling [7,11,12,16,17,18,23,24,25,28,29,30]. Alarms can create an increased sense of security in residents who suffer from cognitive impairments or who are at greater risk of falling [26,27,31].…”

“…Alarms are most impactful in reducing falls for residents with cognitive impairments [7,11,12,15,17,18,19,21,22,23,24,28,32,33,34,35]. Alarms also reduce the burden of care placed upon staff [15,17].…”

“…Staff report that alarms provide an opportunity to provide support when it is needed [18,22,24,28]. Additionally, alarms seem to increase the likelihood of resident and staff interaction, which is directly related to quality of care [17,22,23,28,30]. Improvements in alarm technology are leading to increased device accuracy and increased resident quality of life [11,15,34].…”

Management Team Perceptions of Risks and Strategies for Preventing Falls Among Short-Stay Patients in Nursing Homes

“…16,17 In the current study, most nursing homes use similar devices and alarms, however one nursing home is currently pilot testing an alarm-free initiative, which seems to be a growing phenomenon. 18,19 …”