Ask the Nursing Expert about ... going alarm-free

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Judi Kulus, VP of Curriculum Development, AADNS
Judi Kulus, VP of Curriculum Development, AADNS

Our facility is trying to go alarm-free, but some staff are reluctant to stop using alarms. Any suggestions?

Many staff and family members worry about removing alarms.

It's important to stress that alarms do not prevent falls. Usually alarms simply alert staff that a resident is already on the floor. Worse, alarms often cause residents to avoid moving to prevent the alarm from buzzing, which can lead to a decline in mobility and an increased risk for falls.

Alarms do not serve the goals of a home-like environment and resident-centered care. The incessant racket of alarms can be maddening and negatively impact residents' quality of life, increasing agitation.

Residents who trigger an alarm upon moving often become embarrassed. Additionally, staff tend to get “alarm fatigue,” tuning out the beeping rather than rushing to every active alarm.

Achieving alarm-free status happens when you communicate that alarms do not replace staff monitoring and assistance. They might be helpful for a short time when assessing a resident's life pattern, but after the initial evaluation, an individualized care plan should be created.

An alarm-free facility requires sufficient, competent staff. Using consistent staff who know residents and their care plans will help. Additional interventions can include placing at-risk residents close to the nursing station, requiring that nursing assistants chart by residents' rooms, tailoring toileting schedules to voiding patterns, and encouraging involvement in recreational activities and exercise.

If you were around for the restraint-free movement of the 1990s, you'll remember a lot of nervous pushback. We'll make it through this current struggle too, and then wonder later what took us so long to change

 Please send your nursing-related questions to Judi Kulus at