Multidisciplinary And Complex Nature Of Alarm Management

Sentinel events are a major cause of deaths in hospitals, these deaths may have been prevented if there was not a break down in the communications process. Due to the rise of such events it has been decided that by the Commission that National Patient Goals would include patient safety as an area of focus.

Another strategy could be offering the new customers who opt for an automatic payment service a fixed price for the first three years (not increased by the annual 3% rate). In this case the LTV net of the acquisition costs would be $1305,5, still higher than the one the company would earn whether the customer opts for a not automatic payment. Moreover, offering 8 years of fixed price ($480) is still more profitable than the case in which the chose a not autopay method, but it is, in my opinion, not recommendable, because of the negative effect that it could have on the customer that chose this option before. Indeed they could decide to resign the contract and try to get a new one with the more convenient conditions. (Table 2)

Alarm fatigue is a growing national problem within the health care industry that links medical technology as a serious hazard that poses a significant threat to patient safety within hospitals across the country. Alarm fatigue occurs when nurses encounter an overwhelming amount of alarms thus becoming desensitized to the firing alarms. Alarm desensitization is a multifaceted issue that is related to the number of alarming medical devices, a high false alarm rate, and the lack of alarm standardization in hospitals today (Cvach, 2012). Desensitization can lead to delayed response times, alarms silenced or turned off, or alarms adjusted to unsafe limits, which can create a dangerous situation for the patient. Alarm fatigue

This requires critical thinking and reliance on one's one staff and healthcare system. The healthcare system has many safety measures, such as better medication and patient scanning systems, bed or chair alarms to alert staff, and the call-light system to let patient request staff in a timely manner. Though there are measures in place to try and limit errors they still happen. Even if a patient is on a bed alarm the patient could still fall while ambulating. Safety call-outs are a way to track what happen or almost happen and to further prevent such occurrences from happening again. It goes beyond just blaming one single to person

Given the complexity of healthcare system today, effective and efficient collaboration and communication among team members is critical to ensure patient safety. Daniel & Rosentein (2008) reported that during a typical patient’s hospital stay, a patient may interact with 50 different employees that may include doctors, nurses, laboratory technicians, etc. They also reported that when healthcare professional are not communicating and collaborating effectively, patient safety is at risk for several reasons: break in communication flow, misinterpretation of information, incorrect telephone orders and overlooked orders.

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.

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

Goal 6: Know Your Alarms. Alarms familiarity on your unit is integral to the best patient safety. Take faulty

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).

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

- Risk to patients if the alarm signal is not attended to or if it malfunctions

After exposure to repetitive and continuous alarms, nurses may become desensitized or overwhelmed with the number of alarms to respond to; this phenomenon is known as alarm fatigue (Graham & Cvach, 2010). Alarm fatigue can lead to dangerous practices such as turning off alarms, silencing alarms without evaluating or troubleshooting this issue, changing the alarm parameter to unreasonably broad settings, or complete disregard of the alarm (Ulrich, 2013). A significant contributing factor is the number of duplicate or false positive alarms nurses experience each shift, with studies showing that anywhere from 72-99 percent of alarms in the clinical setting are false or non-emergent (Graham & Cvach, 2010). Although alarm fatigue is commonly associated with critical care areas, it may occur in any patient care area with frequent or repetitive alarms (Gross, Dahl & Nielsen, 2011). In addition to causing a permanent harm or death, clinical alarms also contribute to noise levels in patient care areas, which in turn can cause insomnia or delirium.

The case which best reflects redundancy is the case of O’Brien v Associated Fire Alarms (1969).In this case the applicant was employed to work in Liverpool. Due to the demand of his work his employment was declined. He was then sent to Barrow-In-Furness. His express refusal to relocate resulted in the termination of his contract. The Employment Tribunal held that he was redundant; this was due to there being no mobility requirement within his contract. The case which compares to the case of O’Brien v Associated Fire Alarms (1969) is the case of Bass leisure v Thomas (1994). In this case the company in question looked to move their company 20 miles away from their original premises. In this case the Employment Tribunal argued that the employees

The article that was chosen to write about is alarm fatigue. This article talks about all the alarms that go off on a daily basis, and the implications that can occur, such as patient death, due to the fact that, they may be ignored and not answering them. This can be very scary since it could happen on any units such as the one where the respiratory therapist works. Also, as a result of the implementation of the new charting system, which is very time-consuming, it becomes difficult to attend to the ventilator, when the alarm goes off. The article also stated that based on one research, found 72% to 99.4% of alarms that go off are false, which creates a “cry wolf” situation in which staff will respond to the alarm the percentage of time they

We have gathered the data from the alarm trial over the last two weeks and I will have Donna send that out tomorrow. Not surprisingly the nurses felt there was as an overwhelming increase in the number of alarms and an increase in alarm fatigue. We did recognize another trend that we have not hardwired a culture of recognition that high saturation alarms are dangerous and not without consequence. They tend to understand, but were still treating them as a rather negotiable variable, or an alarm that they could ‘afford’ to just watch. So we have work to there. In my two recent interviews I have been doing more interviewing than being interviewed. In San Antonio after the VONN initiative we all participated in they made their criteria 93-97 from