Alarm Reduction – Fall Prevention

Angie SzumlinskiUncategorized

C0-blogger: Erica Holman, LNHA, LMSW, Risk Manage

Long-term care is “buzzing” with the process of alarm elimination and fall reduction programs.  The good news is that HealthCap members actively implementing alarm reduction programs are reporting their fall rate has not increased and has actually decreased in many cases.  Sounds great, doesn’t it?  However, is the elimination of alarms the cause of the lower fall rates or the result of interventions implemented to reduce falls?

Before you decide to eliminate alarms, review articles discussing successful alarm reduction.  Many states have information on the process of implementing a successful alarm reduction program including It is important to remember that alarm and fall reduction is an Interdisciplinary and comprehensive process.  The first step is discussion and education with the interdisciplinary team to set the tone and set expectations for the program.  The interdisciplinary team must “buy in” and take ownership of the program for it to be successful.  The QA Committee should evaluate current fall rates, identify patterns and evaluate the effectiveness of interventions to establish benchmarks. 

Steps to consider as you implement an alarm and fall reduction program include, but are not limited to the PDSA cycle (Plan, Do, Study, Act):


  • Meet with the interdisciplinary team, families, and other stakeholders to provide education and solicit feedback and ideas on alarm and fall reduction.
  • Educate families on the process of alarm and fall reduction; draw upon their knowledge for individual care planning interventions.
  • Assess residents and determine who may be a candidate for initiating an alarm reduction program.
  • Analyze fall patterns and trends to identify resident needs.


  • Identify a small, manageable sample of residents meeting the criteria for an alarm reduction trial.
  • Remove alarms from this sample of residents for short periods of time while under direct supervision.
  • Based on individual resident fall patterns and trends, expand activity programming and supervision while extending the length of alarm free periods.
  • Increase therapy involvement; provide alternative cushions and positioning devices; adjust wheelchairs and table heights; expand exercise programs in collaboration with restorative and activities; implement walking/gait training/strengthening schedules for residents.
  • Initiate resident centered care plans to draw upon resident strengths in an effort to reduce fall rates; expand on root cause analysis to assist in eliminating causal factors


  • Evaluate outcomes to measure success and identify changes/improvements To the process that may assist in improving outcomes.
  • Evaluate the benchmarking goals; have we met our established goals?  If not, why not?


  • Make changes as needed and implement next phase or reintroduce current phase.

As you move through this process you may identify certain residents where alarm reduction is not appropriate.  Each resident is a unique being and what works for one resident may not work for another.  It is prudent to be “alarm appropriate” by documenting the “why” we do what we do, how we do it, initiate a resident specific care plan addressing risks and continue to provide quality care!  Determine what reduces risk for your residents and implement programs that enhance quality of life and care delivery.  More information on fall reduction is available by contacting your HealthCap risk manager and at

About the co-author:

Ms. Holman is Licensed Nursing Home Administrator with a master’s degree in clinical social work. She entered the healthcare arena working as a counselor in a psychiatric hospital and later trained as a psychotherapist with an interest in depression and anxiety. Ms. Holman began working in long term care as the Director of an Alzheimer unit in the early 1990s and became a Licensed Nursing Home Administrator in 1995. Ms. Holman is an expert in the development and implementation of quality assurance and behavior management programs.