{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:56:01Z","timestamp":1791492961704,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T00:00:00Z","timestamp":1591660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"NIH","award":["R56 AG051799"],"award-info":[{"award-number":["R56 AG051799"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Research in Nursing &amp; Health"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Bed and chair alarms are widely used in hospitals, despite lack of effectiveness and unintended negative consequences. In this cross\u2010sectional, observational study, we examined alarm prevalence and contributions of patient\u2010 and unit\u2010level factors to alarm use on 59 acute care nursing units in 57 US hospitals participating in the National Database of Nursing Quality Indicators\u00ae. Nursing unit staff reported data on patient\u2010level fall risk and fall prevention measures for 1,489 patients. Patient\u2010level propensity scores for alarm use were estimated using logistic regression. Expected alarm use on each unit, defined as the mean patient propensity\u2010for\u2010alarm score, was compared with the observed rate of alarm use. Over one\u2010third of patients assessed had an alarm in the \u201con\u201d position. Patient characteristics associated with higher odds of alarm use included recent fall, need for ambulation assistance, poor mobility judgment, and altered mental status. Observed rates of unit alarm use ranged from 0% to 100% (median 33%, 10th percentile 5%, 90th percentile 67%). Expected alarm use varied less (median 31%, 10th percentile 27%, and 90th percentile 45%). Only 29% of variability in observed alarm use was accounted for by expected alarm use. Unit assignment was a stronger predictor of alarm use than patient\u2010level fall risk variables. Alarm use is common, varies widely across hospitals, and cannot be fully explained by patient fall risk factors; alarm use is driven largely by unit practices. Alarms are used too frequently and too indiscriminately, and guidance is needed for optimizing alarm use to reduce noise and encourage mobility in appropriate patients.<\/jats:p>","DOI":"10.1002\/nur.22049","type":"journal-article","created":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T08:45:15Z","timestamp":1591692315000},"page":"365-372","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Unit\u2010level variation in bed alarm use in US hospitals"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6232-9149","authenticated-orcid":false,"given":"Vincent S.","family":"Staggs","sequence":"first","affiliation":[{"name":"Biostatistics &amp; Epidemiology, Division of Health Services &amp; Outcomes Research Children's Mercy Kansas City  Kansas City Missouri"},{"name":"School of Medicine University of Missouri\u2010Kansas City  Kansas City Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7885-0879","authenticated-orcid":false,"given":"Kea","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Behavior Moffitt Cancer Center  Tampa Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7927-8608","authenticated-orcid":false,"given":"Catima","family":"Potter","sequence":"additional","affiliation":[{"name":"Press Ganey, Inc.  South Bend Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7969-7522","authenticated-orcid":false,"given":"Emily","family":"Cramer","sequence":"additional","affiliation":[{"name":"School of Nursing University of Kansas Medical Center  Kansas City Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7776-7814","authenticated-orcid":false,"given":"Nancy","family":"Dunton","sequence":"additional","affiliation":[{"name":"School of Nursing University of Kansas Medical Center  Kansas City Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine C.","family":"Mion","sequence":"additional","affiliation":[{"name":"School of Nursing The Ohio State University  Columbus Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1457-4668","authenticated-orcid":false,"given":"Ronald I.","family":"Shorr","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Florida  Gainesville Florida"},{"name":"Geriatric Research Education and Clinical Center Malcom Randell VAMC  Gainesville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2008.02.011"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14703"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/PTS.0b013e3182699b64"},{"key":"e_1_2_9_5_1","first-page":"CD005465","article-title":"Interventions for preventing falls in older people in care facilities and hospitals","volume":"9","author":"Cameron I. 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