Unit-level variation in bed alarm use in US hospitals

Area of Science:

• Nursing Quality Improvement
• Patient Safety Research
• Healthcare Technology Assessment

Background:

• Bed and chair alarms are common in hospitals but their effectiveness and consequences are debated.
• Existing evidence suggests limited efficacy and potential negative impacts of alarm use.

Purpose of the Study:

• To investigate the prevalence of bed and chair alarms in acute care settings.
• To examine patient- and unit-level factors influencing alarm use.
• To compare observed alarm use with expected use based on patient fall risk.

Main Methods:

• Cross-sectional, observational study involving 59 nursing units in 57 US hospitals.
• Data collected on 1,489 patients, including fall risk and prevention measures.
• Patient propensity scores for alarm use were calculated using logistic regression.

Main Results:

• Over one-third of patients had alarms activated.
• Patient factors like recent falls and altered mental status increased odds of alarm use.
• Observed alarm use varied widely (median 33%) and was poorly predicted by patient fall risk; unit assignment was a stronger predictor.

Conclusions:

• Alarm use is prevalent, highly variable, and not solely explained by patient fall risk.
• Unit practices significantly drive alarm use, indicating potential overuse and indiscriminate application.
• Guidance is needed to optimize alarm use, reduce noise, and promote appropriate patient mobility.