Nursing homes care for vulnerable residents (children, young adults with disabilities, and the elderly including frail residents with chronic complex illnesses) requiring different levels of medical and nursing care. These residents are monitored continuously to ensure that they remain as healthy and independent as possible, yet safe and achieve the quality of life they desire. Monitoring everyone requires a great deal of effort and time from the nursing care team. With the increasing number of residents to manage, and the various administrative follow-ups to fulfill, the ability to constantly have visibility and oversight of all residents is stretched as nurses are not always able to be physically around all residents or even always have a direct line of sight.
Having to juggle multiple residents and administrative tasks at hand, coupled with the shortage of manpower, there is risk of slow responses or even oversight of residents who might have been injured or in adverse predicaments. Furthermore, the risk of nurses’ burnout rate is high, which may lead to higher turnover rates and increased expenses related to recruitment, retention, and training.
Currently, the challenges faced when monitoring residents:
1. High usage of restraints needing monitoring: Currently the nursing home has approximately 43 to 48 residents in each ward with 8 nurses working the AM shift, 5-6 working the PM shift, and 2+2 for the night shift, an average ratio of 1 nurse : 6-8 residents for the shifts. Of these residents, up to 48% of the residents are on different types of restraints (e.g. mittens, body, pelvic) and require a higher amount of supervision and monitoring.
2. Lack of visibility: Any resident, whether frail or otherwise, incapable or disabled, may find themselves in situations of distress and need for assistance – e.g. bed exit falls, stuck in a stressful bed position – and may not always be able to call for assistance as the nursing staff may not be nearby. Consequently, in the event a resident encounters an unfavorable situation, the nurse on duty may not be aware as they may not be triggered and alerted to the event. Also, other residents may necessitate continuous attention (full 1:1 nursing care and attention). This adds on to the strain of manpower and reduces the supervision of other residents. Moreover, a 1:1 nurse ratio to resident care may not be always sustainable.
3. “Roaming” residents: Ambulating dementia residents may accidentally ‘roam’ to places where they should not. It's common for people living with dementia to wander or become lost or confused about their location, even in familiar areas. They may wander at least once; many do so repeatedly and lose themselves. These ‘roamers’ require monitoring to ensure they do not go astray and could return to their beds.
