News, Skilled Nursing Facility

Ask the expert: Why is it recommended that facilities remove alarms in phases, rather than cold turkey?

Listen in on Tuesday, November 14 as HCPro’s post-acute care regulatory specialist Stefanie Corbett, DHA dives into how to make the transition to an alarm-free facility without compromising resident safety, including how to utilize your QAPI programs to understand root causes for falls, regulatory guidance, and how to achieve culture change through alarm elimination. Click here to sign up!

Q: Why is it recommended that facilities remove alarms in phases, rather than cold turkey? Won’t family members and residents wonder why one unit can have the alarms and another unit cannot?

A: The point of making the transition to an alarm-free facility in phases, rather than cold turkey, is to ensure that you’re not implementing a facility-wide change that may not yield the desired results. Alarms must be eliminated strategically. It’s not uncommon for family members to argue this approach and request that their resident be moved to the unit that still uses alarms, because the family member likely thinks that the alarm is preventing their loved one from falling. However, removing alarms strategically creates a safer, more effective plan, and as research has shown, alarms have proven ineffective at preventing falls.

One strategic approach to eliminating alarms is to follow the Plan, Do, Study, Analyze (PDSA) model. This model requires that facilities evaluate whether their plan is effective from the point of implementation. To begin the planning process, facilities should select a control group of residents such as a certain number of residents per unit, only new admissions, or only residents who trigger their alarms most often.

Next, leaders must ensure that everyone in the facility is on board, as well as residents’ family members. Education is key to culture change and helping correct alarm myths (i.e., they prevent falls).

Once you’ve gained staff buy-in, establish a time frame for your controlled study. As you begin to eliminate alarms, you may find that your facility needs to change the way that it invests its resources, or that staff need to be redistributed based on residents’ acuity levels. Observing a small population of residents or a specific unit at a time can help your facility determine what changes are most appropriate. Facilities should also make sure that their activity program has made the necessary changes to staffing models, care plans, and supplies to engage residents with varying cognitive levels, different interests, and at peak times for resident falls (i.e., after lunch). Making these changes to a smaller population makes it easier to analyze the results through processes such as QAPI and root cause analysis.

Unfortunately, we don’t always know what areas in our plan need revision or correction until we have something happen that wasn’t in our plan, which is why eliminating alarms in phases is the better approach.