Last November the Centers for Medicare and Medicaid Services (CMS) required facilities to document the use of bed and chair exit alarms. Many see this as the first step in an effort to ban their use, treating them as a form of restraint. If you bring this up among professionals, you’re bound to hear an interesting and engaging debate. Some are a firm yes, others are no, and many are somewhere in between.
The overwhelming argument against the use of alarms is the noise they make, and few if any disagree with this. Imagine trying to sleep when every movement causes an alarm to blare out and staff to rush into your room? It’s terrible, and many studies have shown that audible alarms cause more falls than they prevent. They scare residents, disturb sleep, and confuse caregivers who can’t tell what room the alarm is coming from.
The secondary argument is that alarms create negligence among caregivers. Using this logic any alarm is bad because it teaches staff to be reactive, rather than understand and anticipate a residents needs. There is a lot of debate around this reasoning. Does a tool like an alarm create negligence, or is it organizational culture?
Another less philosophical issue with alarms is alarm fatigue. Studies have shown that traditional alarms are as low as 60% accurate, leading to many false alarms. When 40 out of every 100 alarms is false, staff learn to quickly ignore them.
The encouraging news is that new technology can help make alarms silent and more accurate. These are not insurmountable problems, and in fact this is something we’re doing at upBed today. The discouraging news (for us) is that we’re not sure how to solve the perceived negligence problem. Is it a problem? Our view of this is a bit skewed, but it goes something like this.
If you are doing 15 minute rounds, what happens during the 14 minutes you’re not watching the resident? There is real risk and problem here, and if a silent alarm exists that is 100% accurate wouldn’t this be a good thing? Better yet, what if the same underlying technology could learn to predict when someone will wake up, giving caregivers advanced notice. Is this an alarm? Does this create negligence?
These are interesting questions. Our macro concern is that far-reaching legislation to ban all alarms could stifle innovation that the healthcare space desperately needs. But we’re interested in learning from your opinion. Where do you stand on this debate and how are you responding to it?