Exploration of staffs’ perceptions of the use of bed alarms on the Aspen unit at St. Vincent’s Langara Residential Care Researchers: Karima Kurji, Clinical Nurse Leader, Bina Randhawa, RN, Jane Wong, RN, Jo-Ann Tait, Operations leader and mentor
INTRODUCTION/BACKGROUND St. Vincent’s Langara Residential Care (SVL) is 197 bed long term care facility within Providence Health Care located in Vancouver. At St. Vincent’s Langara Residential Care, falls prevention strategies include bed alarms that have been designed to automatically monitor when a resident is positioned on a bed sensor pad. Staffs often find bed alarms malfunctioning, unplugged or damaged, rendering them ineffective. The reasons for the ineffective use have not been explored. The purpose of this study is to explore registered nurses’ and resident care aides’ perceptions of using bed alarms in order to increase bed alarm effectiveness.
METHODS A qualitative descriptive design that consisted of 3 one hour focus groups with a convenient sample of 21 Resident Care Aides (RCAs) and Registered Nurses (RNs) on the48 bed Aspen Unit at St. Vincent’s Langara Residential Care. Questions for the focus groups: 1. What do you think about using bed alarms? 2. How do bed alarms help or not help the resident who is at risk for falls? 3. What are the problems you encounter with bed alarms? 4. What would help you use the bed alarms effectively? The focus groups were digitally recorded and transcribed by a professional transcriptionist. Content analysis technique was used to explore the transcript data in a systematic manner. Staff words and phrases were coded and then grouped into categories and themes. A final focus group was held with participants to confirm that the categories and themes accurately reflect their perceptions.
RESULTS- Themes Theme Category 1 Sub-categories Codes
Safety Protects Residents Appropriateness Suitable (AS) Evaluation (AE
Category 2 Sub-category Codes
Barriers Equipment Failure Function/Works (EF) Breakage (EB) Device (ED) Tampering Device (ED) location Devise(ED) New Tech/System Device (ED)-call bell Cords (EC) Strips (ES)- Position Strips (ES)- Expiry/Availability Strips (ES)- Dates
Theme Category Sub-category Codes
Emotional Well-Being Emotional Impact of using bed alarms Dignity Nuisance Privacy (DP) Staff (NS) Emotional Impact (DE) Residents (NR) Others (NOF)
Staff Awareness Alert Staff (SA) Response Time (SR)
Staff Observation Fall Prevention (SPV) Not Preventing Fall (SNPV) Comfort for resident and family (SC)
Inadequate training Education on Set up (TS) Education on Use (TU) Orientation (TO)
Environment Environment Can’t hear Call Bell (SEC)
DISCUSSION/IMPLICATIONS • There is agreement that bed alarms do alert staff; however, some staff thought that bed alarms prevented falls and others disagreed, which is consistent with the literature. •In the literature review, researchers found a study done in critical care areas on clinical alarms but there was no literature focused on the reasons bed alarms are not used safely or effectively in long term care facilities •Although the sample size was small (21 which was 57% of the staff) , results may be generalized to all long term care sites that use bed alarms that have been designed to automatically monitor when a resident is positioned on a bed sensor pad. •There are many issues with the current bed alarm system such as tampering, inconsistent location of the controller, cords getting tangled, and sensor pads expiring, which may support use of a different system or improve current process. E.g. consistent location of the device for easy access on nights, and list of residents with alarms and when pads expire to reduce false alarms. •Ongoing evaluation needs to occur to ensure that the bed alarm is still useful for the residents. •During orientation, there needs to be some education on the setup, use and trouble shooting of bed alarms, and regular replacement of sensor pads.
CONCLUSION The following needs to occur to increase effectiveness of the bed alarms: current processes need to be improved to reduce false alarms, regular evaluation of the need for the bed alarms for residents, a consistent location of device, properly secured cords, and appropriate education on the bed alarm system.