Appropriate Alarms Toward Patient's Safety

Patient safety is of utmost importance to prevent errors and adverse effects associated with patients in health care. Yet, 44,000 to 90,000 people die each year from preventable medical errors (Potter & Peter) caused by human factors. According to World Health Organization (2009) human factors is defined as:

378). Hospitals have an array of medical devices at the bedside that have alarms, which have grown significantly within recent years. Nurses may be exposed to over 350 physiologic alarm monitors per day, resulting in sensory overload thus leading to desensitization. When the alarm sounds it should be corrected immediately, even though it may be a false alarm or no issues with the patient. The Joint Commission has identified alarm fatigue as a 2014 National Patient Safety Goal, requiring hospitals “to establish improvement of alarm system safety as an organization priority” (as cited in Horkan, 2014, p. 83). Alarms are deliberately designed for high sensitivity so that nurses do not miss a true event. Firing alarms are usually muted, disabled or ignored by nurses altogether because alarms are viewed as a nuisance. Alarm hazards have generated national attention, in one highly publicized case an alarm sounded for 75 minutes before a nurse responded to a patient’s heart monitor that needed a battery replaced. When the nurse finally went to change the battery the patient was found unresponsive and could not be resuscitated because he had gone into cardiac arrest (Sendelbach & Funk, 2013). The patient’s heart monitor battery eventually died and did not issue the critical alarm alert. In another event, a patient fell getting out of bed and bleed to death because the nurse

Back in 2003, the Joint Commission created a National Patient Safety Goal due to 23 occurrences of death or injury to a patient where alarms had been applied incorrectly or the alarms had been muted (Sendelbach & Funk, 2013). By 2004, Joint Commission had removed it from their National Patient Safety Goal list and made it a requirement for Joint Commission accreditations (Sendelbach & Funk, 2013). In 2013, it was brought to the attention of the Joint Commission regarding many alarm-related events, including multiple deaths, permanent loss of function, and prolonged hospital stays due to health care worker’s decreased response times to alarms (Horkan, 2014; Joint Commission, 2013). The Joint Commission reinstated a National Patient Safety Goal in 2013 and had requirements for all hospitals that had to be met by July 1, 2014 (Joint Commission, 2013). These goals included being able to make alarm safety a priority and develop a plan to decrease the amount of alarms. This plan could include preventing unnecessary patient monitoring, clarifying who is allowed to monitor and silence alarms, setting the cardiac monitors to have multiple tones, and having a brief delay in the alarm to see if the patient can self-resolve. The second phase of the Joint Commission’s plan was to be implemented by January 2016, to where the hospital must have followed through with their designated plan (Joint Commission, 2013).

Clinical alarm systems in acute and critical care health care settings are an assistive way to maintain communication between the client and the nurse. Awareness and comprehension of health devices is crucial to provide nurses with appropriate strategies for critical or non critical interventions that can lead to sentinel events. The ECRI, a nonprofit institute, has identified alarm hazards as the “Top Ten Health Technology Hazards” for 2014. (cite) In 2013 The Joint Commission published a Sentinel Event Alert proposing a National Safety Goal to focus on alarm safety (cite). This topic is pertinent information to be recognized and set as an achievable action in improving patient safety.

In general, there is a need for patient safety improvements. However, the good new is, that there have been some slow improvements, including a better foundation to address patient safety. A good example is the annual Agency for Healthcare Research and Quality (AHRQ) survey designed to help healthcare organizations compare their safety record to other health care organizations. Over 600 hospitals participate each year in the volunteer survey. The results of the survey provide a baseline to track and evaluate patient safety interventions (Para. 15).

This paper examines this culture of alarm fatigue among nurses in clinical care areas and the resulting potential for harm among the patient population. Although alarm fatigue may happen in any clinical area with frequent or repetitive alarms, this paper focuses on the phenomenon in critical care. The broad scope of this issue coupled with the high risk of patient harm demands insight and action from the nursing profession. By discussion and review of contributing factors such as repetitive alarms, noise level, lack of individualized settings, poorly configured devices, and desensitization of nurses, healthcare providers can strategize methods to prevent patient harm resulting from alarm fatigue. These measures also promote efficiency

The Pennsylvania Patient Safety Authority is a state agency founded by the Medical Care Availability and Reduction of Error (MCARE) on 2002. Moreover, the agency creates the greatest database system for patient safety which known as Pennsylvania Patient Safety Reporting System PA-PSRS. The system was developed by contract with Pennsylvania-based independent, ECRI, in partnership with Hewlett Packard Enterprise, a non-profit health services research agency, the Institute for Safe Medication Practices (ISMP), a Pennsylvania-based, non-profit health research organization and also a leading international information technology firm. Statewide compulsory for using PA-PSRS to report serious events in hospital, ambulatory surgical facilities and

crucial in the safety of patients. The Informatic Nurse Specialist along with the nurse manager and alarm committee will individualize and customize alarm thresholds to limits that are clinically appropriate for individual patients to decrease the incidence of nuisance and false alarms that distract staff members and contribute to alarm fatigue ( Cvach,2012; Evans,Shumante & Lovelace, 2011). Staff will be re-educated on the appropriate use of alarm systems to help minimize the effects of nuisance and false alarms. When staff are appropriately trained on how to fully utilize equipment, clinically signicant

With the proliferation of technology in the today’s healthcare environment, the healthcare community is increasingly concerned about the patient safety risks associated to clinical alarm hazards. In 2012, 2013, and 2014, the Emergency Care Research Institute (ECRI) identified clinical alarm hazards as a high priority potential danger area in hospitals and health systems (ECRI, 2014). The Joint Commission, the American Association of Critical-Care Nurses (AACN), the Food and Drug Administration (FDA), ECRI, and the Association for the Advancement of Medical Instrumentation (AAMI) have all identified the need to address alarm management and alarm fatigue as a priority patient safety concern (Horkan, 2014). In response to these concerns, federal regulatory mandates are increasingly coupled with recommended alarm management practices and protocols. Despite these focused efforts, alarm fatigue and alarm management continue to be priority national patient safety concerns.

Eric, thank you for choosing such a significant topic for your paper. Alarm fatigue is a big problem in the healthcare field. Sentinel events related to alarm fatigue is something that is totally preventable. It’s interesting our body gets trained and used to hearing certain sounds after awhile where we don’t find these sounds even bothersome. Or we have developed a way to block out these sounds and still stay focus on our task at hand. If an alarm has the option, I like to change my patient’s alarm sound to a sound that I don’t hear often so that way it quickly catches my attention and my coworkers as well during my shift. I work in the ICU where I am closely monitoring my two patients and every bed has a bed alarm built inside the mattress.

Let me expand on your response to Debra’s post. Are we so busy running around taking care of numerous patients that we get caught up in desensitization of alarms? I have to concur with you that ignoring alarms is not an option, those nurses who jeopardize the safety of patients are only making a fool of themselves. We all know what the end result might be. It is in our jurisdiction to protect our patients by making sure that they are free from harm; therefore, regardless of how many times an alarm is sounding, we should make sure to check the patient. One of the disadvantages is that there are times when we are busy with another patient and cannot respond to an alarm. This is why it is important that nurses collaborate so that we do not

Take a second to imagine you are a father, who has an infant admitted to the neonatal intensive care unit (NICU) for the first time. How are you feeling? Afraid? Confused, even? If your baby is admitted to the NICU, your first question probably will be: What is this place? With equipment intended for infants and medical staff specially qualified in newborn care, the NICU is an intensive care unit created for sick newborns who require specialized treatment. A common example for parent’s

Nursing and healthcare continue to change on a daily basis. The one thing that has remained constant during these changes is maintaining the safety of our patients. By maintaining their safety, nurses must ensure that they are keeping up-to-date with the changes in technology now being introduced in healthcare, new and emerging diseases, new equipment, and changes in treatment modalities. One such responsibility is ensuring that nurses do not operate equipment they were not oriented to or trained to use in an effort to prevent injury patients. Nurses and other healthcare professionals are being held accountable for practicing within their scope of practice based on their licensure regulations, and the company policies and procedures. Therefore, nurses are responsible for their professional growth and practice by ensuring that they comply with the necessary standards required by their profession.

Multiple sources cite false alarms in anywhere from 72-99% of all alarms (Ensslin, 2014; Meeks, 2014; Sendelbach & Funk, 2013). Clinical alarms are in place to enhance patient safety by alerting health care workers to deviations in predetermined normal status (Sendelbach and Funk, 2013), but with up to 1000 electronic alerts and alarms each shift, it is difficult to know which alarms to respond to (Duggan, 2016). In labor and delivery, two lives are depending on the nurse to know which alarms are important to respond to. In addition to the safety of the patient, persistent alarms affect the labor experience of the patient and family, contributing to increased stress and anxiety and decreasing the holistic experience (Meeks, 2014). Many times

Noises are one of the most prominent concerns that patients had. In order to solve this problem, Tinsley should make a regulation for employees to talk at a lower voice. In addition, in order to reduce the noise coming from moving wheels of stretchers, wheelchairs, and carts through the hallways; lubricants must be applied to the wheels regularly to keep them smooth and soundless. Since the buzzer system rings loudly in the hallway as well, a system can be implemented in order for them to ring only at the nurses’ desks so that other patients would not be bothered by the noise.