The prevalence of personal alarms in nursing homes can undermine care and even induce falls, warn authors Carmen Bowman, MHS and Theresa Laufmann, RN in the Action Pact workbook, Alarms: The New Deficient Practice? Eliminating Alarms and Preventing Falls by Engaging with Life.
“Staff admit they develop a tolerance for alarms sounding and tend to ignore them or not run so fast anymore,” the authors state. Personalized care often is sacrificed to overreliance on the devices, they add.
Their warning is corroborated by a recent National Public Radio (NPR) report on how “alarm fatigue” has become a top patient-safety concern in hospitals. Subjected daily to thousands of sounding alarms – hospitals nurses receive a stimulus overload that, along with the inevitable, alarm-related technical glitches, can be fatal.
“Patients can die when an important alarm is missed, or an electrode on a patient’s chest comes unstuck, or a monitor’s battery goes dead,” reports NPR correspondent, Richard Knox. An investigation by the Boston Globe found that 200 deaths nationally in 2011 are attributed to alarm problems.
Meanwhile, Boston Medical Center has countered alarm fatigue by greatly reducing their use, which in turn has improved the moods of both patients and staff.
“As the research continues to come out about ‘alarm fatigue’ causing accidents, we predict the tides will turn and alarms will be viewed as deficient practice,” says Bowman.
Alarm fatigue is but one of the many compelling arguments she and Laufmann present for eliminating alarms in long-term care. They show how resident safety can be improved without alarms through greater personal engagement and vibrant living.
“CMS states in Tag F323 Accidents, ‘Alarms do not replace necessary supervision,’” says Bowman. “At Tag F221 Physical Restraints, CMS states they can be used for an immediate episode such as coming out of anesthesia but then are no longer to be used after the immediate episode.
“Our workbook also shows how alarm use can be deficient practice under requirements F241 Dignity; F242 Choices; F155 The right to refuse treatment; F151 Same rights as any US citizens; F252 Homelike environment; F258 Comfortable sound levels; and F520 Quality Assessment and Assurance/QAPI. Thus, the title of our book, Alarms: The New Deficient Practice?” Bowman concludes.