Hospitals rank alarm fatigue as top patient safety concern

Clinicians exposed each day to tens of thousands of alarms
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Nineteen out of 20 hospitals surveyed rank alarm fatigue as a top patient safety concern, according to the results of a national survey presented last week at the annual meeting of the Society for Technology in Anesthesia.

Alarm fatigue occurs when clinicians become desensitized to the constant noise of alarms or overwhelmed by the sounds and turn alarms down or off. The problem has become so widespread that last month The Joint Commission named it a National Patient Safety Goal and now requires accredited hospitals and critical access hospitals to improve their systems.

"Hospitals are greatly concerned about alarm fatigue because it interferes with patient safety, and it exposes patients--and the hospitals themselves--to grave harm," said Michael Wong, executive director of the Physician-Patient Alliance for Health & Safety, who presented the findings at the annual meeting.

The findings show hospital staff are exposed to an average of 350 alarms per bed, per day based on a sample from an intensive care unit at the Johns Hopkins Hospital in Baltimore. "That translates into thousands of alarms per unit and tens of thousands of alarms per hospital each and every day," Wong said.

To reduce alarm fatigue and better manage alarms, Wong said hospitals must develop a systemic approach that considers staffing patterns, care models, architectural layouts, patient populations and staff responsibilities. "Among the most critical considerations are the capabilities and configuration of technology," he said.

Almost nine out of 10 hospitals surveyed said they would increase their use of patient monitoring devices that incorporate capnography and/or pulse oximetry if they could reduce false alarms.

"What's also notable is that a majority of the surveyed hospitals--70 percent of them, in fact--expressed a need for a single assessment indicator," Wong said. "They believe that a single indicator to assess the patient's pulse rate, exhaled carbon dioxide, respiratory rate and oxygenation would be crucial in reducing alarm fatigue and improving alarm management."

Alarm fatigue also is considered the leading health technology hazard, according to the ECRI institute's top 10 health technology hazards, FierceHealthIT previously reported.

One way hospitals can combat the problem is to follow the lead of Boston Medical Center (BMC), which has reduced its weekly audible cardiac alarm rate by 89 percent simply by adjusting monitor alarms for bradycardia, tachycardia and heart rate limits.

"While some hospitals are looking to add technology to combat this issue, BMC's approach demonstrates the opportunity for clinicians to interact with current alarm systems more effectively to decrease clinical alarm fatigue while simultaneously capturing and displaying all important alarms," said James Piepenbrink, director of clinical engineering at BMC and co-author of the BMC study published in the December issue of the Journal of Cardiovascular Nursing.

To learn more:
- here's the study results (.pdf)
- read the announcement

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