Fall Prevention In Hospitalized Patients: Bed Alarms Research Papers Example
Type of paper: Research Paper
Topic: Nursing, Bed, Patient, Fall, Health, Medicine, Health Care, Actions
Patients are vulnerable to falling off hospital beds. Falling might be an accident during sleep, or sometimes a result of the patient’s actions such as trying to leave the bed unattended. Most patient-falls result in serious injuries especially because patients are weak and have not a little or no control over their bodies. As a result, healthcare facilities have come up with various intervention measures and strategies to help reduce and prevent the falling of patients off their beds. These measures include motion sensors, cameras to monitor movement and bed alarms. Remarkably, hospital facilities develop such interventions to reduce the extra cost of treating injuries caused when patients fall. The use of bed alarms has had prevalence as the most preferred way of preventing patient falls. Bed alarms are meant to notify the clinical staff of any anomalies in the patient room (Covinsky, 2012). The alarms are set to go off in case the patient leaves the bed unattended or when they do something unusual.
Furthermore, it should be noted that bed alarms are also meant to reduce restraint use. Whenever an attempt is made to leave the bed, the bed alarms notify the staff that, on the other hand, correspondingly reacts swiftly. A significant aspect to note is that; bed alarms do not prevent falls by themselves and neither are they restraints. They are set to warn the staff of an unaided attempted move out of bed (PA PSRS, 2004). In some cases, they even warn the patients themselves. While most professionals have questioned the significance and practicability of bed alarms, researchers and non-governmental organizations, they remain a common practice in healthcare. In fact, bed alarms are used more than any other intervention measures. Therefore, it is significant that one understands the practicability of bed alarms, their strengths and weakness in order to decide on whether bed alarms are a fundamental step towards preventing patient falls in hospitals.
Initially, healthcare facilities used restraints to prevent patient falls. Notably, restraints seemed to work well but, had consequences that were far much worse than falling. For instance, it would lead to agitated behavior, constipation, anger, accidental strangulation, humiliation, emotional desolation and sometimes even death (Geffre, 2008). However, in the last two decades, due to the advancement in technology, interventions to reduce patient falls have been increased. The use of bed alarms has been one of the most celebrated interventions. Bed alarms come in many different forms. These include placing a pressure sensitive pad beneath the patient. The pad is usually placed at the buttocks area or the shoulder area (PA PSRS, 2004). The pad is then connected to a control panel that of either placed on the bed or a nearby wall. When a patient attempts to leave the bed unattended, the pressure in the pad reduces and consequently the alarm goes off. Notably, studies have shown that sometimes the bed alarms are a great nuisance to patients in cases where they merely try to change sleeping positions. Nevertheless, the feasibility of bed alarms remains a greater issue of concern.
Bed alarms normally warn the caregiver or clinical staff that a patient has changed their original position and that they are just about to leave the bed. Therefore, the caregiver has more than enough time to get into the patient room and assist the patient in moving about. Particularly, the issue of concern, in this case, is the response that is required when the alarm goes off. Entering the room on time helps the patient move about more appropriately, hence, avoiding the fall, in general (Geffre, 2008). Notably, one of the initial counter-measures of reducing the impact of falls was coming up with soft and pliable floors. This was such that, when the patient falls, the chances of getting injured were reduced. However, a fall cannot be necessarily on the floor; instead, it can be on something hard like a table, sink or even some kind of steel hospital equipment. Thus, it is significant to avoid the fall in the first place, rather than to deal with its negative effects. Bed alarms guarantee that, with quick caregiver response, patient falls can be avoided altogether. In essence, as much as bed alarms do not prevent the fall by themselves; they give caregivers a fundamental opportunity of averting patient falls.
Additionally, bed alarms also notify clinical staff and caregivers when a patient has already left the bed. In the hospital setting, there are many instances in which patients might attempt to move around. First, they may be leaving the bed to attend to a short or long call. Secondly, they may be attempting to grab an object in the room vicinity such as prescription medicine or food. Additionally, they may be leaving to go outside the room for fresh air. Thus, when a patient has already left the bed, bed alarms go off to warn the caregivers (PA PSRS, 2004). Remarkably, the caregiver is to intercept the patient before they fall quickly. However, in case the patient has already fallen, the caregiver, through the bed alarms has enough time to respond more swiftly to alleviate and deal with the effects of the fall. The original purpose of restrictive measure was to reduce the impact of a fall (Geffre, 2008). Thus, this can also be achieved by the use of bed alarms when clinical staff responds more promptly to a fall situation, allowing for immediate and emergency treatment procedures.
It has also been noted that bed alarms, apart from just warning the caregivers when patients leave the bed, can also be used to warn the patient themselves that they are on the verge of doing something that they are not required to do. However, research has shown that a bed alarm can go off even at the slightest of an unintended move by the patient. Hence, some patients may view the bed alarms as a nuisance that might cause annoyance and irritation. Nevertheless, at the sound of a bed alarm, the patient is reminded of calling for assistance from the caregivers rather than moving about on their own (PA PSRS, 2004). Thus, it is most likely that when a patient hears the alarm go off, they will be prompted to sit back and wait for assistance. On average, patients would rather be assisted than do specific tasks on their own. Preliminarily, bed alarms act as the best way of averting a patient fall. Situations where patients are prompted to sit back when the alarm goes off, prove that bed alarms are indeed a fundamental measure of preventing falls in hospitalized patients.
In a hospital situation, patients are sometimes dizzy for illness and treatment procedures and thus, may feel weak and confused. Furthermore, most patients who have been known to be vulnerable to falling in most cases are elderly patients. Falls are characterized by a patient’s attempt to ambulate independently without seeking prior assistance. In essence, the institution of bed alarms on wheelchairs and patient beds is a positive move in ensuring that patients are assisted at all times and that there is no risk of falling. While there has been no evidence of preventing patient falls by themselves, bed alarms are still widely used in most health care settings especially in the USA (Covinsky, 2012).
Many studies have been conducted to establish the viability and practicability of bed alarms and the need of using them as a fundamental intervention measure of preventing patient falls. As noted earlier, bed alarms are not only useful for healthcare staff but also an assistive measure of allowing patients wait for assistance than ambulating by themselves. Fundamentally, preventing the fall and alleviating the risks and effects of the fall are defined by the response that caregivers give to the sound of the alarm. Thus, as much as the system is care-based, it is an outstanding measure towards effective healthcare practice. Notably, the effectiveness of healthcare practice is determined by how well a health care facility supports good health, improves lives and saves lives. Thus, bed alarms are one way of ensuring effective, practical healthcare service to patients. It is a cost-saving mechanism, given that it eliminates the financial burden of fall-related injuries and effects on a patient.
Conversely, there have been arguments about the significance and reliability of bed alarms as an intervention for preventing patient falls. First, these arguments have been based on the costly nature of installing bed alarms versus the fact that they do not prevent the fall themselves. Most studies conducted on how bed alarms are applicable to healthcare facilities have determined that bed alarms, most of the time, fail to achieve their ultimate purpose that is preventing falls (PA PSRS, 2004). While other interventions such as restraints, despite their negative effects, have been known to prevent patient falls in a better way, bed alarms are simply a warning sign that the fall is about to happen (or has happened) but do not prevent the fall (Covinsky, 2012). Researchers argue that preventing patient fall is not necessarily subject to technical procedures such as bed alarms whose viability and cost are not proportional. Most studies have revealed that human solutions are better than depending on costly technology to improve medical practices.
Another significant aspect relating to bed alarms that has been the center of argument is the consent of patients on whether the bed alarms should be fitted on their beds or not. Patients are not consulted on the installing of bed alarms on their beds or wheelchairs. At a glance, it violates ethics in health practice. As much as the alarms may be useful to both the patient and facility, patients have a right to decide whether to have them installed or not. Furthermore, it has been established that bed alarms sometimes become a source of nuisance when they keep on ringing even at the slightest of an unintended move (Covinsky, 2012). Such nuisance could lead to annoyance and irritation that, on the other hand, might lead to agitation and anger. The last thing one should see in a healthcare facility is an agitated, angry patient. Their resultant actions might be far much worse than just falling. Hence, evidence of annoyance from the bed alarms proves that the system might be not reliable or feasible especially in a healthcare system. It calls for more considerable interventions.
Another argument for the use of bed alarms is based on how the system is more of activity restrictive. The alarms, fitted on either the bed or wheelchair, restrict the patient from initiating any activity. Critically thinking, elderly patients are the most vulnerable to falling. Thus, when their beds and wheelchairs are fitted with alarms, they cannot conduct any activity involving movement of the body. If this goes on for a long time, the patients might easily acquire hospital-based disabilities (Covinsky, 2012). Sitting or sleeping in one position for a long time might paralyze significant organs in the body. In essence, patients need to be encouraged to move about and ambulate freely to facilitate muscle relaxation and body fitness. Restricting mobility has adverse consequences that would be costlier to deal with. Furthermore, because bed alarms have not proven to reduce patient falls, it is uncertain whether they the perfect intervention or reducing falls. Studies propose more of human solutions than technical solutions in reducing patient falls.
Nevertheless, despite these arguments, bed alarms remain to be sensible, realistic and useful in averting patient falls. As an early warning sign and indicator, bed alarms are crucial in ensuring that caregivers intercept an independent ambulation before a patient falls. Furthermore, it is practical that bed alarms signify when a patient has left his chair/bed or when they have made a move (Geffre, 2008). This allows caregivers to respond quickly and assist the patient where possible to avoid a fall. Quintessentially, bed alarms are the best fall-prevention interventions in hospitalized patients.
Covinsky, K., (2012). Bed Alarms in Hospitalized Patients: Useless. Retrieved from <www.geripal.org/2012/11/bed-alarms-in-hospiatlized-patients.html>. Accessed on 2nd March, 2015.
Geffre, S., (2008). Bed Alarms: Investigating Their Impact on Fall Reduction and Restraint Use. St. Alexius Medical Center, 900 E. Broadway, Bismarck.
PA PSRS. (2004) Bed Exit Alarms to Reduce Fall Risk. Retrieved from <www.patientsafetyauthority.org/ADVISORIES/Advisorylibrary/2004/sep1 (3)/pages/14.aspx> Accessed on 2nd March, 2015.