Use Patient-Centered Practices to Prevent Nursing Home Falls

CMS nursing regulations

Nursing homes across the country are increasingly phasing out bed and chair fall-prevention alarms. That’s because physician-conducted studies have found consistently that alarms do not prevent falls, and can even create unsafe conditions for residents. Plus, the Centers for Medicare and Medicaid Services (CMS) is no longer keen on the use of alarms. In other words, this is a trend you can’t afford to ignore.

Although it can be daunting to figure out how to protect patients without alarms, moving toward a more homelike environment where providers know patients’ needs well will provide much better outcomes in the long-term, says compliance expert Carmen Bowman in her live webinar with ProfEdOnDemand.

During her discussion on patient-centric practices to reduce falls, Bowman takes you through the research so you can get both your staff and your patients’ loved ones on the same page in seeking efficient ways to improve patient care and prevent injuries.

The Real (Bad) Effects of Alarms

Alarms are just one chapter in the story of nursing home care. They were introduced in the 1990s after  the 1987 Nursing Home Reform Act prohibited physical restraints. Although alarms, which sense shifts in weight, theoretically provide residents with more mobility (at least compared to restraints), CMS asserts that, rather than keep residents safe, alarms often actually cause residents to be more afraid to move when they need to for fear of tripping the alarms.

The potential negative effects of alarms include:

  • Loss of dignity
  • Limited mobility
  • Incontinence
  • Disturbed sleep, and
  • Negative emotional responses to the alarms, such as confusion, fear or anxiety.


Underlying all these disadvantages is the potential alarms create for patient neglect. “We’re putting alarms on residents so we can forget about them,” said a director of nursing at a Wisconsin facility that began reducing alarms back in 2016.

An environment where residents are forgotten until alarms are sounded is obviously not ideal for a facility that wants to provide the best quality of life for its residents. But then how can you ensure your staff is being proactive enough to prevent falls without alarms?

Create a Plan Unique to Your Facility

The key to going alarm-free, say analysts at HealthLeaders Media, is to start with a thorough evaluation of what your residents need—as well as how your facility is equipped to meet these needs (and what areas require improvement). Be prepared for this to be a longer process than expected, and keep residents and their loved ones updated on the process.

It’s important to not rush through this preparation phase. Thorough root cause analysis and planning can provide the foundation your facility needs to implement a successful program.

Remember: Don’t just copy a strategy that worked successfully for another nursing home. Your alarm elimination plan should be as unique as your facility—as your capabilities and your patients.

Stand Your Ground

When it comes time to implement your new fall-prevention program, be prepared to meet resistance. Residents’ loved ones will be concerned that going alarm-free will increase, not decrease, the possibility of injuries. And staff may balk at having to completely re-learn how to handle routine situations previously covered by alarms.

Rest assured that recent research shows eliminating alarms leads to a more relaxed environment and reduced resident injuries.

Do this: Hold consistent training and workshops on proactive fall prevention to build awareness among both families and staff about this improved trend in resident care.

Most importantly, make sure your facility personnel continues to stay up-to-date on best practices for fall prevention, says Bowman. It’s up to you to find better, more effective ways to guard the safety of your residents now that alarms are passé.

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