Question

As ICU RN, alert fatigue was real with the beeps of IV pumps, bedside monitors, ventilators, and call lights just to name a few. All of these alerts/beeps had a reason to alert clinicians to an issue such as occluded IV line, abnormal vital signs, high pressure on the vent or a patient needing assistance. With the addition of the EHR, and clinical decision alerts, the bedside clinician has even more alerts to address during their shift causing alert fatigue. There needs to be a better way to help the clinicians differentiate the different alarms and address alert fatigue. What could be some strategies to help address alert fatigue?

Answer 1

The sheer volume of alarms in the typical hospital room causes alarm fatigue: Clinicians experience sensory overload from the excessive number of alarms and become desensitized, which can lead to longer response times or critical alarms being missed altogether.

A study at Johns Hopkins Hospital found that 350 alarms were produced per bed during a single day in an intensive care unit.

Strategies include.

1.Accept

8 Ways to Reduce Alarm Fatigue in Hospitals

September 19, 2017

The sheer volume of alarms in the typical hospital room causes alarm fatigue: Clinicians experience sensory overload from the excessive number of alarms and become desensitized, which can lead to longer response times or critical alarms being missed altogether.

Interested in reading a nurse’s perspective on alarm fatigue? Read more.

Alarm fatigue isn’t something that only large health systems experience. If you work in a hospital of any size, chances are high that you are exposed to the sounds of alarms beeping and buzzing all day long. Modern hospitals foster a highly computerized clinical environment, resulting in nearly everything being hooked to a monitor that can make audible noises—falsely or otherwise. More than 19 in 20 hospitals are concerned with alarm fatigue and the potentially detrimental effect it can have on patient safety.

A study at Johns Hopkins Hospital found that 350 alarms were produced per bed during a single day in an intensive care unit. When alarms function as intended—sounding when medical action should be taken—patient safety is enhanced. However, alarms sounding all day, every day, lead to such extreme desensitization that many alarms simply aren’t heard, they are disabled, or they aren’t triaged appropriately. In fact, many hospitals aren’t fully utilizing the technology available when it comes to monitoring patients in order to avoid adding another beep to the mix. Nearly nine out of 10 hospitals (88 percent) would “increase their use of patient monitoring devices that incorporate capnography and/or pulse oximetry if they could reduce false alarms.”

The alarm fatigue epidemic needs to be resolved in order to increase patient safety and decrease sentinel events related to poor alarm management. Here are eight ways to help diminish the din of alarms throughout your hospital, improve patient safety, and boost clinician satisfaction:

1.Clean and Monitor the Equipment

Cleaning and replacing electrodes, or ensuring that a monitor is working as it should.

Regularly changing single-use sensors and establishing routine times to inspect, clean, and maintain equipment helps keep everything working properly. It also reduces the frequency of alerts related to technical malfunctions, like a low battery or loose connection.

Replacing aging monitors with new technology.

Cleaning or replacing electrodes daily also helps, as fresh electrodes deliver high-quality tracings and better skin-electrode contact.

2.Decrease Clinically Inconsequential Alerts

Cut back the number of alarms that sound due to a clinically inconsequential event.

3.Funnel Alerts to the Right People

Clinical alerting solutions today make it possible for different alarms to be routed directly to the appropriate person. By bypassing the nursing station and sending alerts to the right on-duty clinician’s preferred mobile device (smartphone, Wi-Fi phone, tablet, or pager), hospitals can reduce the number of calls or overhead announcements that have to be made. This reduces the amount of noise and promotes an environment for resting and healing.

4.Stop False Alarms

False alarm refers to an instance when monitoring equipment indicates a physiologic event, when no actual event occurs. Research shows that 72 to 99 percent of alarms are false.

5.Triage Alerts with Software

Nurses and physicians can get help triaging alarms with the help of intelligent software. Clinical alerting software can act as the first stage of triage by “incorporating the facility’s preset priority levels and using built-in logic to pass along the highest levels of alerts first.” This makes the job of the nurse more efficient through enhanced meaningful communication: They only receive alerts to their mobile device that require immediate attention and are actionable.