Boston hospital cuts cardiac-unit alarm use by close to 90 percent

Boston Medical Center was able to reduce audible alarms in its cardiac unit by 89 percent, with no adverse events, using a series of interventions aimed at reducing "alarm fatigue," according to an article at AHRQ's Health Care Innovations Exchange.

The Joint Commission has named the desensitization to the plethora of alarms in hospitals a National Patient Safety Goal and now requires improvements from accredited hospitals and critical access hospitals.

A second AHRQ feature profiles similar efforts at Dartmouth-Hitchcock Medical Center to reduce the number of alarms in orthopedic and other post-surgery units.

Boston Medical Center's interventions included:

  • Expanding the default parameters that trigger alarms due to low and rapid heart rates
  • Differentiating between "warning" alarms that do not require a nurse response to "crisis" and alarms that do
  • Adding an audible alarm for atrial fibrillation episodes to the existing visual alarm
  • Allowing two nurses to collaborate to change alarm parameters for individual patients (with a physician's approval)

Beyond the improvements in the cardiac unit during the six-week trial, an expansion to nine adult medical-surgical units reduced audible alarms by 60 percent. The expansion included alarms for oxygen saturation rates and blood pressure, while the test in the cardiac unit focused solely on alarms based on heart rate and arrhythmias.

In addition, Boston Children's Hospital has teamed up with a startup to use a data-driven approach to forecast problems before alarms sound.

Meanwhile, University of Arizona associate professor Eve Edelstein is collaborating with UC San Diego music and sonic arts professor Peter Otto on a sound bender--a small machine that directs sound solely to those who need to hear it.

To learn more:
- here's the Boston Medical Center piece
- read the Dartmouth-Hitchcock Medical Center article

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