Team-based approach cuts alarm fatigue by 80 percent

A standardized, team-based approach could dramatically cut the use of cardiac monitor alarms and reduce alarm fatigue--a top health technology hazard and hospital patient safety concern, according to a study published in Pediatrics.  

Clinical alarms are designed to alert nurses to a significant clinical problem that needs immediate attention. But the alarms sound so often--and usually as a false alert--that nurses become desensitized to the sound and may not respond to a true event. As a result, alarm fatigue is fast becoming a significant patient safety hazard.

To reduce alarm fatigue, researchers at Cincinnati Children's Hospital Medical Center, led by Christopher Dandoy, M.D., of the hospital's Cancer and Blood Diseases Institute, created a standardized cardiac monitor care procedure for the hospital's 24-bed pediatric bone marrow transplant unit.

As part of the project, Dandoy and his team developed a process for ordering monitor parameters according to age-appropriate standards, pain-free daily electrode replacement, personalized daily cardiac monitor parameter assessment and a reliable way of appropriately discontinuing monitors. Under these protocols, the median number of daily cardiac alarms fell from 180 to 40, while caregiver compliance increased from 38 percent to 95 percent.

"Cardiac monitors constitute the majority of alarms throughout the hospital," Dandoy said in a hospital announcement. "We think our approach to reducing monitor alarms can serve as a model for other hospitals throughout the country."

Fewer false alarms, he added, will allow hospital staff to devote more attention to significant alarms. Although the process was enacted in a pediatric unit, Dandoy and his team said it was applicable to "most units with cardiac monitor care."

The concern over alarm fatigue is so great that last December, the Joint Commission named alarm fatigue reduction a National Patient Safety Goal and requires accredited providers to improve their alarm systems to reduce it.

"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 findings at the Society for Technology in Anesthesia, earlier this year that 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.

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.

To learn more:
- read the study abstract
- here's the hospital announcement

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