How the nursing home ensures the quality of alarm use

Alarms are a crucial part of the safety and security in nursing homes. They help both residents and staff to quickly connect when needed and can prevent serious accidents. However, for the alarms to fulfill their function, they need to be handled correctly, function as they should, and the staff need to be knowledgeable about how they are used. How can the nursing home ensure that alarms are used in a way that both creates security for the residents and facilitates the work for the staff?

Different types of alarms in the nursing home

In a nursing home, there are several different types of alarms, all with the aim of increasing safety and security.
Safety Alarms – Residents can alert themselves when they need help, for example, in case of pain, discomfort, or a need to use the bathroom.  
Motion Alarms – Used at risk of falls and can be activated when a resident gets out of bed or leaves their room.  
Bed Alarms – Alarms that sense if a resident leaves the bed during the night and does not return within a certain time.  
Door Alarms – Important for people with dementia who may run the risk of wandering off.  
Alarms linked to medical equipment – Used to monitor, for instance, oxygen concentration or other medical needs.  
Alarms in bathrooms and toilets – Enable rapid assistance if a resident needs help.  

How can we ensure that the alarms work?

For alarms to be a reliable safety measure, regular checks and maintenance are required. It is important to:

Regularly test the alarms – Ensure that all alarms are tested according to a fixed routine, for example, weekly or monthly.  
Check batteries and function – Batteries in alarms and sensors must be replaced before they run out to avoid the alarms stopping working.  
Have clear procedures for reporting faults – If an alarm does not work, there should be a clear process to quickly rectify the problem.  
Ensure that all employees know how the alarms work – New and existing employees should receive regular training in how different alarms work and how they are correctly handled.  
Document incidents and follow up – If an alarm has not worked or if it has not been handled correctly, this should be documented and analyzed to avoid repetition.  

How can we use alarms effectively?

It is important that the alarms are used in the right way to create security – but also to avoid unnecessary alarms that can create stress and deteriorate the working environment.

To improve the use of alarms, the nursing home can:
Make recurring individual assessments – All residents have different needs. Some need motion alarms, others perhaps safety alarms. An individual assessment of which alarms are needed should always be made.  
Avoid residents alerting unnecessarily – Some residents alert repeatedly out of anxiety or loneliness. In some cases, it may be better to look at other measures, such as more social support or closer supervision.  
Ensure that the alarms are not accidentally turned off – Staff should be aware of how the alarms work to avoid them being turned off or not registering the right events.  
Prevent problems through good planning – If the staff knows that a resident often needs to use the bathroom at a certain time, they can proactively offer help instead of waiting for an alarm.  

How can we follow up response times and identify areas for improvement?

That the alarms work is one thing – but they also have to be answered on time. Long response times can lead to residents feeling insecure, that care needs are not met in time and, in the worst case, to serious accidents.

To ensure that the alarms are answered in a reasonable time, the nursing home should:
- Follow up response times in the alarm system – By analyzing alarm statistics, the operation can see if there are times of the day or specific units where the response times are longer than desired. There may also be reasons to see if the response times are longer some days or on some units.  
- Review staffing at times with high workload – If the statistics show that the response times are longer at certain times, the staffing may need to be adjusted.  
- Engage in dialogue with residents and relatives – By talking to the residents and their relatives, the operation can get a better picture of how the alarms work in practice and what areas for improvement there are.  

Reflection questions - Alarm control

Care staff:  
- Do you know how all the alarms work and how they should be handled?  
- Have you ever noticed that an alarm did not work as it should? How was it handled?  
- How do you view the balance between using alarms and working preventively to reduce the need for alarms?  

Manager, nurse, occupational therapist, and physiotherapist:  
- How do you ensure that the staff have the right training about alarms?  
- Are regular checks made to ensure that the alarms work?  
- Do you analyze alarm data to see if the alarms are used optimally and if the response times are satisfactory?  

Residents and relatives:  
- Do you feel that the alarms work as they should?  
- Do you feel safe that the alarm will be quickly answered when needed?  
- Are there occasions when you or your relative had to wait too long for help after alerting?  

Erland Olsson
Specialist nurse
Sofrosyne - Better care every day.