Hello everyone, my name is Dana Rohrbaugh and I’ve been an ADN prepared RN for 15 years.  Prior to that I earned a bachelors in psych from KSU and then stayed home with my children for a decade before going to nursing school.  I’ve been married 22 years and have three adult children.  I’ve worked in ortho/neuro for a few years but have predominantly worked in acute rehabilitation with some time spent specifically in a brain injury unit.  I currently work in acute rehab in Lawrence KS full time as a charge and staff nurse and am finally working toward my BSN.

Our unit is the pilot study floor for the use of integrated bed alarms in our hospital.  We are using beds that have alarms built in to the bed and are using alarms on all patients unless they are up ad lib.  Because many of our patients have compromised cognitive abilities due to various factors like dementia, CVA, or other sources of impairment, and because they are typically on our floor to gain strength and mobility, independence with ADLs, etc, we find we have a lot of patients attempting to ambulate by themselves before they are safely able to do so.  This led to increased falls.  Since we began the pilot study we have seen a drop in patient falls.  I haven’t yet seen the data so I’m unable to determine if it is a significant decrease, but I look forward to examining that.   Falls *seem* to have dropped but that perception will have to be compared to real data.  The question of alarm fatigue arose early in the study and is something we have to continually address when we find people slowly answering an alarm.

Because of previous experiences at other rehab hospitals I was able to introduce our unit’s speech therapist to Free Water Protocol cups that deliver only 10 ml of pure water with each tip of the cup to individuals with swallowing precautions.  She and I are putting together literature and costs to support purchase of these cups by the unit. This would help combat dehydration among patients who reject thickened liquids while keeping them safe and preventing aspiration pneumonia.  We hope to use research evidence to support this change and justify its related costs, which really are fairly minimal.  I look forward to learning how to do this properly in this class and help change care for my patients by using evidence based best practices.