profession

Solutions for "alarm fatigue" are complex

Customizing default settings and properly maintaining batteries are among ways to combat staff becoming desensitized by thousands of alerts. A long-term plan also is important.

By Carolyne Krupa — Posted Aug. 4, 2010

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Monitors beep, infusion pumps buzz and ventilator alarms sound. Such signals are routine at hospitals, but sometimes they're so routine that they become background noise, eliciting little, late or no response from those they're designed to alert.

Too often, medical professionals become desensitized -- overwhelmed by the sheer number of clinical alarms constantly pulling them from one patient to the next, said Kathryn M. Pelczarski, director of the ECRI Institute's Applied Solutions Group.

"Alarm fatigue is a pervasive problem that can lead to missed alarms and delayed alarm response," she said. "And missed alarms and delayed alarm response can lead to patient harm, and even patient death."

Pelczarski spoke July 21 during a Web conference on how to combat clinical alarm fatigue, which was hosted by the ECRI Institute, a nonprofit health services research organization based in Plymouth Meeting, Pa.

Alarm fatigue is a "vexing problem in clinical medicine," said Julian M. Goldman, MD, medical director of biomedical engineering for Partners HealthCare System and attending anesthesiologist at Massachusetts General Hospital.

Pelczarski said solving the problem requires long-term dedication. Hospitals and their care units must evaluate their needs and develop alarm management plans. Responsibilities should be delegated and staff should be able to tailor alarm defaults for particular units or patients, such as adjusting a monitor alarm for a long-distance runner with a lower heart rate than average.

Low-battery alarms can be minimized by routine upkeep. Staff members should be taught to apply monitoring devices properly and keep probe sites clean, Pelczarski said.

Johns Hopkins Hospital in Maryland began a pilot project in its medical progressive unit in December 2005 to prevent clinical alarm fatigue, said Maria Cvach, RN, the hospital's assistant director for nursing. An internal evaluation found that 16,934 alarms sounded in the unit during an 18-day period.

"It's actually staggering when you look at it," Cvach said.

The hospital formed a task force that examined the purpose and accuracy of alarms within the medical progressive unit. Default alarm settings were adjusted to appropriate levels, and staff underwent alarm management training, said Kelly Creighton Graham, RN, a patient safety analyst and consultant with ECRI.

The result was a 43% decrease in critical alarms. "It was a vast improvement and the beginning of a culture change," Graham said.

Developing plans is just the first step. Progress should be monitored continually, staff members should be held accountable to ensure they stay engaged in the process, and hospitals and equipment manufacturers should collaborate to make improvements, Dr. Goldman said.

"That technology is always changing, so it's important to keep abreast of what is out there," Cvach said.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn