Short Term Care Institutions

Bed and Chair Alarms in a Short-Term Care Facility

The nursing problem

The short-term care facility registers a rather increased rate of falls among its patients, from both beds as well as chairs. In some of these cases, the injuries associated with the falls are rather severe, and in a small percentage, they are even fatal. The nursing staffs seek to prevent patient falls from occurring, but being understaffed and working in a demanding environment, guarding each patient at all times is virtually impossible.

A longitudinal analysis of the patient falls in the short-term care facility has revealed that the problem is a rather constant one, without major fluctuations having been observed in the falls registered by patients from beds and chairs. In order to address the matter, a solution is proposed in that of integrating alarms in the bed and chairs used by the patients at the short-term care facility. The beds and chairs would, as such, contain built in sensors to alert the nursing staffs when a patient is at risk of falling. The mechanism by which the alarm would alert the staffs of falling risks is that the sensors would be able to identify when the patient changes the weight pressure in the chair and the bed, by moving in manners which endanger their safety and stability within the bed and the chair. By assessing the patient movements then, the sensors would alert the staffs of risks and the nurses could intervene in order to prevent the fall.

"The primary purpose of bed and chair alarms is to alert staff to a potential fall when a resident attempts to get out of bed or up from a chair. Bed and chair alarms are typically pressure sensitive devices placed in beds, chair pads and wheelchair seats that respond to changes in pressure with a warning signal" (Horowitz, 2014).

Barriers to implementation

The theory of using bed and chair alarms within the short care facility is sustained by the science of the pressure points which could alert when falling risks occur. Besides this sound argument however, there are numerous counter-arguments to implementing the personal alarms. Some of the most relevant of these barriers to bed and chair alarm implementation include:

The patients exhibit higher levels of distress and anxiety when they are being constantly monitored

The usage of the alarms implies additional costs as well as new operations within the care facility, which will produce disturbances in operations and patient care

In order for the nurses to be able to prevent the fall once this is alerted, they need to be in the immediate proximity of the patient, otherwise, they will, at most, be altered that someone has fallen and will then provide after-the-fact assistance

It is unrealistic to assume that all nurses will be in the immediate proximity of patients at all time and will be able to prevent falls that will take place within seconds

The massive data so far collected from other care facilities which have shown that the usage of bed and chair alarms does not in fact reduce the number of falls. For instance, a study published in 2013 and completed in 16 nursing units, on a total of 27,672 inpatients has revealed that there indeed existed a general tendency among nursing care facilities to use more bed and chair alarms, but that an increase in their usage has revealed "no statistically or clinically significant effect on fall-related events" (Shorr, Chandler, Mion, Waters, Liu, Daniels, Kessler and Miller, 2013)

Another study has revealed that the bed and chair alarms can be counter-productive in that they tend to foster a false sense of security, meaning that the nursing staffs are less concentrated on actions to prevent falls, but more concentrated to manages falls that have already taken place and have been alerted (Horowitz, 2014).

Solutions to overcoming the barriers

A first aspect that has to be addressed is represented by the fact that the studies mentioned throughout the previous section focus on patient falls within the long-term care facilities, where staffs are the primary caregivers of the patients. Within these facilities, nursing shortages make it virtually impossible to be on constant watch of patients and prevent falls, and the nurses come to manage after-fall instances. Within the context of short-term care however, the patients who come in are themselves better able to take care of themselves; they are in better health conditions than the patients in long-term care, meaning that they themselves could be alarmed by the bed and the chair and could themselves intervene to change their position and make sure they do not fall. Additionally, these patients also normally come accompanied by someone, be them a friend, a spouse, a son, a daughter and so on. This means that there is always someone by their side who can quickly respond to the alarm and intervene to prevent the patient from falling and becoming more injured.