Icu Alarm Management

Pamela F. Cipriano, President of American Nurses Association was in disbelief to see how she has tried to enforce the Nightingale pledge of keeping patients free from harm was failed because medical errors are the third leading cause of death in the United States. As of now ANA has conducted yearlong campaign named “Safety 360 It Starts with You” in order to reduce and take measurable advances to protect the welfare of nurses and workers. It is one of campaign that the ANA comes with that is in support to both the nurses and patients. However, in the real-world nurses are stress and fatigue due to patient ratio. In my workplace, which is a state hospital, they have full time nurses on call where nurses work more than 70 hours a week. The nurses

Horkan, A. M. (2014). Exploring the Evidence Alarm Fatigue and Patient Safety. Nephrology Nursing Journal, 41(1), 83-85.

The preventable barriers identified are classified into consistent themes such as communication, interface between medical staff and fear. Aiken et al. (2002) reported that nurses contribute importantly to surveillance, early detection and timely interventions due to findings that linked association with staffing levels to patient mortality and morbidity. But higher emotional exhaustion and greater job dissatisfaction in nurses credited to the poor management of deterioration, as nurses may develop poor attitudes to intervene. Jones et al. (2006) identified lack of deterioration perception as a cause of not prompting physician review. Additionally, experiencing information overload eroded perception of deterioration as nurses felt concerned about looking stupid. Bogossian et al. (2014) supported this claim as results derived from stimulations foretold participants did not feel empowered escalate protocols as staff feared consequences, was uncertain and become deskilled in management of emergencies.

Alarm fatigue in health care has grown to be an ever-growing concern in the health care arena, especially when looking at patient safety concerns. There must be an understanding of the problem before we can develop policies and effective strategies to counter this problem. The concept of alarm fatigue in health care will be evaluated utilizing the method developed by Walker and Avant (2010) that identifies and gives the significance of the attributes, antecedents, and end-consequences of alarm fatigue in health care. This will be developed based

Alarm fatigue is recognized by The Joint Commission as a serious patient safety issue, with alarm mismanagement as being the root cause of alarm fatigue (The Joint Commission, 2013). Numerous regulatory and nursing organizations have published strategies to manage alarm fatigue, however evidence is lacking on the best methodology of educating nurses to alarm management. Put one or two lines of the problem the spurred this project. The aim of this study is to compare the effect of online education methodology versus traditional education methodology on the number of false and non-actionable alarm in a cardiac intensive care unit. Historically, the cardiac intensive care unit continues to have an excess number of false and non-actionable alarms despite previous attempts at raising awareness of alarm fatigue. Chapter three will describe

The broad research problem leading to this study is the belief that nursing shortage in facilities leads to patient safety issues. The review of available literature on this topic shows strong evidence that lower nurse staffing levels in hospitals are associated with worse patient outcomes. Some of these outcomes include very high patient to nurse ratio, fatigue for nurses leading to costly medical mistakes, social environment, nursing staff attrition from the most affected facilities. The study specifically attempts to find a way to understand how nurse

In Cvach’s (2012) article, an integrated review synthesized research and non-research findings of seventy-two articles, published between 1/1/2000 and 10/1/2011. The author used the John Hopkins Nursing Evidence Based-Practice model to measure and evaluate the articles for this review. The data collected were categorized into 5 main themes: excessive alarms and the effects on nurses, nurse's response to alarms, alarm sounds and audibility, technology to reduce false alarms, and alarm notification system (Cvach, 2012). The purpose of this integrated review was to find out if the volume of noise (false alarms vs true alarms) disrupts the nurse’s response and perception to physiologic clinical alarms. The 3 main recommendations provided by the researcher were to implement the use of smart technology, generate change within the hospital's environment and protocols, and use of precautionary measures by healthcare staff in order to reduce monitor alarm fatigue.

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

Significance: Because nursing is the largest health care profession and nurses provide most of the patient care, and as an acute nurse, I can relate to how unsafe nurse staffing/low nurse-to-patient ratios can have negative impact on patient satisfaction and outcome, can lead to medical and/or medication errors and nurse burnout. It can also bring about anxiety and frustration, which can also clouds the nurses’ critical thinking. Most patients might not know the work load on a particular nurse and can assume that her nurse is just not efficient. Doctors also can become very impatient with their nurses because orders are not being followed through that can delay treatments to their patients. There is also delays in attending to call lights resulting in very unhappy patients who needed help.

I chose to write about this article on alarm fatigue. It talks about all the alarms that go off daily and how this can cause patient deaths because too many alarms means we just ignore them but sometimes they're real and that patient may die because we don't answer the alarm. I'm afraid this could happen on the unit where I work as a respiratory therapist. We're so busy with our new computerized charting that we don't have time for ventilator alarms that are always going off for no reason. The article says one research study found the percentage of false alarms ranges from 72% to 99.4%, which creates a "cry wolf" situation in which staff will respond to the alarm the percentage of time they deem it reliable. There are several suggestions for

Adequate nurse staffing is clearly a crucial element in safe, effective hospital care. A 2011 study by nurse researchers concluded that adding more nurses to a unit markedly improves patient outcomes and safety in hospitals (Griffith, Ball, Murrel, Jons & Rufferty,

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

Alarm fatigue is a critical problem in health care setting. Nurses may not respond to alarms because they know that most of them are false or non-actionable. Sometimes, the alarms become the noises that nurses no longer hear because they are heard all the time. In addition to ignore alarms, nurses may also reduce audible alarm levels, change alarm limits, and inappropriately silence or deactivate alarms (Cvach, 2012). The alarm fatigue has led to sentinel events and deaths of patients (Cvach, 2012). Therefore, the alarm fatigue problem has to be fixed in order to improve patient safety. This paper will introduce interventions based on evidence-based practices and leadership theories related to alarm fatigue prevention.

The project was designed to compare false, non-actionable alarms prior to education on the evidence-based strategies to reduce alarm fatigue, after online education and then again after traditional face-to-face education. The project included nurses in the 14 bed cardiac intensive care unit, within a 456 bed, not-for-profit

Urgency of acute care varies depending on the situation but can range to anything from emergency surgeries, to injuries, chronic illnesses, and also for the recovery of those procedures. Majority of the patients in acute care settings are critically ill. Nursing responsibilities in acute care settings are vital to patient’s recovery due to the front line position nurses play as well as the wide variety of tasks carried out. Assessments are made during every encounter the nurse has with the patient along with monitoring the patient’s progress. Nurses are responsible for recognizing symptoms the patient may be experiencing due to illness or injury and whether they fall in the spectrum of normal reactions. Vital signs are measured routinely and can be indicators of the patient’s current status. When vitals are questioned diagnostic tests can be arranged to further assess possible comorbidities the patient may have. Care plans are made to plan interventions the health care team can take to help patients through challenges they face, both physical and mental. Nurses administer medications as well as first aid as needed. They are responsible for maintaining special equipment patients may require including monitors and ventilators are well.