Sounding off on personal care alarms: Enough already
Jacqueline Vance, RN
We all know how technology is supposed to help us. And for the most part, it does. But sometimes, too much of something isn't a good thing. I'm talking about personal care alarms. While they have become more sophisticated and more technical, we as human beings have not.
One can only take so much beeping and buzzing and chiming and dinging before we become deaf to it. There is actually a phrase for this: alarm fatigue. (I know … I wrote about being tired last blog but I'm not exhausted now. I'm just on sensory overload).
All this “noise” is overwhelming. How to you distinguish whose bed, chair, wander, IV, door or whatever alarm is going off? Where do you run? And, let's face it, once that bed or chair alarm has sounded, that resident is most likely on the floor. Evidence shows they don't prevent a fall. It's just one more noise to check on. (OK, I may be being a bit too cynical. At least we'll know to go check on someone.)
I read an article that said alarms can actually be harmful. Hmmm ... Alarm Harm? Has a nice “ring” to it (couldn't resist). If some alarms are distracting and not clinically relevant, then why have them? It harms the patients if all they do is distract the staff or become white noise in the background. How many emergency alarms can you have? How do you distinguish the true emergency from the notification?
Now, I'm not saying all alarms are bad things and to throw the proverbial baby out with the bath water, but you need to make a very educated decision about what alarms to have.
Your answer isn't to “alarm” the heck out of everything to impress the survey agency. (Yes, I am talking to you!). According to an article by Graham and Cvach (“Monitor Alarm Fatigue: Standardizing Use of Physiological Monitors and Decreasing Nuisance Alarms.” Am J Crit Care January 2010.9:28-34) alarms are not a “one size fits all” for any institution. You need to carefully examine your specific patient population.
We know long-term care facilities are like snowflakes; no two alike right? This is a QAPI project in the making. Figure out exactly where alarms will benefit your specific population the most.
Then ensure accountability. Who is to react to the alarms, especially when staff assigned to specific residents with alarms are off the unit. Also, think about getting rid of antiquated systems like overhead paging. It is very disturbing for residents and just adds to the background noise. Invest in some wireless communication technology.
So make wise decisions. Be smarter about alarm use — before all you have is white noise, instead of the right noise.
Just keeping it real,
The Real Nurse Jackie is written by Jacqueline Vance, RNC, CDONA/LTC, a 2012 APEX Award of Excellence winner for Blog Writing. Vance is a real life long-term care nurse who is also the director of clinical affairs for the American Medical Directors Association. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. She has not starred in her own national television series — yet. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates.