Plan of Action: Monitor and Alarm Fatigue

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

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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

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.

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.

Alarm fatigue is out of control, and patients are being harmed, if not killed. Alarm fatigue is a disturbing subject in healthcare and primarily in the acute care setting in all institutions. In the acute care setting, alarm fatigue is the constant barrage of noise consisting of an excessive amount of information being communicated by medical devices such as blood pressure, intravenous pumps, and electrocardiogram machines. Alarm fatigue is a nationwide concern and the Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience database received 566 details of patient deaths related to medical device alarms between 2005 and 2008 (Bai et al., 2014). Deaths are normally attributed to the physiological or chronic health of the individual, not alarm fatigue. In 2010, an analysis exposed 73 alarm-related deaths with 33 directly linked to physiologic monitors (Cvach, 2013). Routinely alarms are intended to warn the clinician to situations that deviate from what is conceived as ‘normal’ for the patient, not a stressful, irritating barrage of noise.

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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.

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

According to the Joint Commission 2014, clinical alarm systems are designed to alert staff for any potential patient problems, but they can jeopardize the patient safety, if they are not managed and responded properly. Nurses are known for their ability of multitasking, but everything has a limit. Due to multiple interruptions and distractions, including alarms systems, nurses develop alarm fatigue and try to tune them out and ignore them. "Alarm fatigue occurs when clinicians become desensitized and nonreactive to the sensory overload created by an overwhelming number of alarms, many of which are nuisance or non-actionable alarms” (NACNS 2013-2014).

I work as a Clinical Staff Nurse at what is commonly referred to as the Seattle Veteran’s Hospital, technically it is the Veteran Affairs (VA) Puget Sound Health Care System: Seattle Division. Our Medical/Telemetry unit has 30 beds: four are private rooms, four are 4-bed rooms, and five are 2-bed rooms. Just the bed situation alone creates challenges since the majority of our patients have PTSD and other psychiatric issues in addition to whatever diagnoses necessitated hospital admission. In addition to telemetry monitoring, one of the 2-bed rooms is also set up for continuous EEG and video monitoring for seizure patients. This translates to a lot of different alarms ringing virtually non-stop. In addition, our patients’ conditions range from: failure to thrive requiring tube-feeding, to

Distractions and interruptions consist of anything that disrupts an individual from the current task by diverting one's attention. The advancement in technology has greatly contributed to the increase in the number of distractors in our environment. Most of the technological devices have become part of us since we need them for connectivity, comfort and work. In the Health care industry, many medical devices have alarm systems. Examples include: bedside physiologic monitors such as ECG (electrocardiogram) machines, pulse oximetry devices, and monitors of blood pressure and other parameters; infusion pumps; and ventilators. These alarm-equipped devices are very essential in enhancing and providing safe care to patients. However, these devices

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The rate of Mortality in the health care sector is most times caused by delayed response to patients in the various wards of a medical centre of which an increase in the number of nurses to patients’ ratio will only have a minor effect to cushion this. therefore, a distress alert system goes a long way in dealing with such occurrence in the health sector thereby decreasing the rate of mortality which in turn gives a level of assurance to patients in the medical centers.