Alarm fatigue tops health technology hazards list

The ECRI institute released its top 10 health technology hazards list yesterday, bringing to attention that with new innovation comes great responsibility--for training, implementation and day-to-day use.

"All of the items on the list represent problems that can be avoided or risks that can be minimized through careful management of technologies," the report states. "For this Top 10 list, we focus only on what we call generic hazards--problems that result from the risks inherent to the use of certain types or combinations of medical technologies."

The top 10 include:

  1. Alarm hazards
  2. Infusion pump medication errors
  3. CT radiation exposures in pediatric patients
  4. Data integrity failures in EHRs and other health IT systems
  5. Occupational radiation hazards in hybrid ORs
  6. Inadequate reprocessing of endoscopes and surgical instruments
  7. Neglecting change management for networked devices and systems
  8. Risks to pediatric patients from "adult" technologies
  9. Robotic surgery due to insufficient training
  10. Retained devices and unretrieved fragments

With alarm hazards topping the list, ECRI points out that excessive numbers of alarms lead to fatigue and ultimately, patient harm. Just last week, a study in the Journal of the American Medical Informatics Association reported that providers override about half of the alerts they receive when using electronic prescribing systems. Furthermore the study found that only about half of those overrides are medically appropriate.

And in respect to the No, 4 risk--data integrity failures in EHRs and other health IT systems--just yesterday, two health IT experts contended in an article published by the Journal of the American Health Information Management Association that health information exchange organizations (HIOs) routinely put data security at risk through five risky practices.

There is ample evidence that No. 9 on the list--robotic surgery due to insufficient training-- is risky. It seems new reports wanring of the danger is released every month  For example, complications from robotic surgery are widely underreported, according to a study published in August in the Journal for Healthcare Quality. In March, the American Congress of Obstetricians and Gynecologists said that robotic surgery for hysterectomies should not be a first or even second choice for women undergoing routine procedures, due, in part, to the learning curve associated with the robotic system.

ECRI points out that there's currently no widely recognized requirements for robotic surgery training and credentialing programs.

To learn more:
- see the report (registration required to download)

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