Alarm fatigue continues to be a problem for hospitals, so much so that last fall, it topped the ECRI Institute's annual list of technology hazards. To that end, researchers at the University of California, San Francisco, monitored one month's worth of alarms at the facility to determine the alarm causes, as well as potential solutions to fatigue.
In a study published this week in PLOS ONE, researchers logged more than 2.5 million hours of patient-monitoring alarms over 31 days. The alarms were used for 461 patients in five intensive care units at UCSF Medical Center. Many, according to the researchers, were caused by inappropriate user settings and computer algorithm deficiencies.
In a subset of more than 1.1 million arrhythmia alarms, 88 percent were found to be false positives due to computer algorithm deficiencies.
"If only one alarm in 10 is a true arrhythmia, it is not surprising that this 'cry wolf' phenomenon results in staff ignoring alarms," the researchers said. "If, however, the arrhythmia algorithm could identify a non-artifact lead for analysis and reduce the false alarm rate, clinicians would rapidly perceive that alarms were clinically meaningful and respond accordingly."
Senior study author Barbara Drew, of UCSF's department of physiological nursing, called her team's findings "staggering" in a related announcement.
"There have been news stories about patient deaths due to hospital staff silencing cardiac monitor alarms and alerts from federal agencies warning about alarm fatigue," Drew said. "Our results shed light on the high prevalence of alarms that are mostly false and provide insights into the causes of so many false alarms."
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 published last summer in AHRQ's Health Care Innovations Exchange.
Still, a patient early warning detection system that alerts hospital staff to minor changes in a patient's conditions helped St. Joseph Mercy Oakland Hospital in Michigan slash mortality rates by 35 percent, a clinical informatics staffer at the hospital said in a recent interview.