Recently, in an attempt to prevent patient falls, Union hospital administration and management are more closely enforcing the use of bed exit alarms for patients classified as high fall risk. Patients are classified as high fall risk based on a nursing assessment tool, which uses a point scale to identify patients at high risk of falling. The nurses of 2D; an orthopedic, neurological and urological surgical unit, have stated that the assessment tool is too sensitive and it triggers positive for patients who should not be classified as high fall risk. The nurses have also stated that the majority of the patients on the unit at any given time are classified as high fall risk. All patients who are classified as high fall risk are required by policy to have a chair alarm or bed exit alarm activated at all times, except when accompanied by staff or family. Previously bed or chair alarms were used based on nursing judgment and demonstration of need. Since all high fall risk patients have activated bed or chair alarms, it is commonplace to hear alarms unintentionally activated by patients shifting position or due to nursing and other departments such as occupational or physical therapy, moving patients. Nurses are no longer responding promptly to the alarms. The purpose of the high fall risk system is to identify patients requiring special attention. If all or most patients are high fall risk then no patients receive special attention. One nurse stated this is "the boy who cried wolf."
The goal of the intended strategy is to minimize the number of patient falls by identifying who is at risk with the assessment tool and implementing preventive interventions to reduce this risk. This screening program is useful only if there are effective interventions for patients at high risk and the assessment tool is effective in raising staff awareness of the risk of patient falls.
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