The Role Of Nurses And Health Care Workers

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

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

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

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.

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

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.

Despite the concern for patient safety amongst healthcare leaders, the American healthcare system is experiencing major problems with patient safety and medical errors. Per the World Health Organization, “as many as 1 in 10 patients are harmed whilst receiving health care”. “Approximately 43 million safety incidences occur each year”. “Medication errors costs 42 billion US dollars annually”. The connection of nurse fatigue and its adverse events on patients is substantiated in numerous studies The AHRQ performed a study that indicated shifts longer than 12 hours were substantially associated with increased nursing errors. It further

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.

Safety is a small measure that can make a big impact on a patient in the clinical setting. In some cases, it can even cost patients their lives. According to the Online Journal of Issues in Nursing, safety is defined as a tool to minimize risk of harm to patients and providers through both system effectiveness and individual performance (Barnsteiner, 2011). Safety problems can range from the nurse not knowing how to work certain equipment, or the nurse recording values wrong because he or she is distracted. Either way, these safety issues impact the clinical setting in a negative way. In order to have a functional, safe clinical environment, time and money must be spent to keep the hospital in working order and the nurses in the correct mindset.

Alarm fatigue was brought into the spotlight in recent years because of adverse patient outcomes. These sentinel events triggered the Joint Commission to make alarm safety a goal in 2014, and mandating policies and procedures to be in place by 2016 for better monitoring and observance of alarms. I decided to highlight this topic since a large part of a critical care nurse’s daily routine is silencing alarms for monitors, pumps, ventilators, beds and call lights. In my personal experience inappropriately set parameters for monitors can lead to sensory overload for staff, patients and families leading to a less than desirable work and care environment. In most cases false alarms can be minimized with simple interventions, alerting staff to real situations requiring intervention.

The author of this journal was asked a very serious and relatable question to many nurses, “You just completed a 12 hour night shift and the day staffing ratio went from 6:1 to 14:1, what will you do in reference to staying or going and why?” Regardless if a nurse is fatigued or a unit is short staffed, there are many issues that may occur in the workplace that could jeopardize the quality of care for a patient. That said, this journal will primarily be focusing on patient safety. Factors that are detrimental to patient safety, while maintaining relevance to the asked question, are sleep deprivation and inadequate staffing of nurses.

The role that nurse practitioner (NP) plays within the increasing complex health care system is a constant changing role with the Consensus Model and the introduction of the Affordable Care Act in 2010. The scope of the nurse practitioner (NP) includes the care of the young, the old, the sick and the well. The educational needs of a nurse practitioner vary greatly from that of a Registered Nurse (RN), in the amount of education as well as the focus of the education. NPs provide coordinated primary care with the use of comprehensive health histories and physical examinations, diagnosing and treating acute and chronic illnesses, the management of medications and therapies, ordering and interpreting tests results, and educating and

Nurses are known as the heart of health care. Being a nurse is a demanding job that requires commitment, but does not lack rewards. A fact stated by the American Association of Colleges of Nurses claims that “Nurses comprise the largest single component of hospital staff, are the primary providers of hospital patient care, and deliver most of the nation 's long-term care” (“Nursing Fact Sheet”). With many roles throughout the healthcare system as a whole, nurses are a large, very important role that interacts with every other part of the health care system. They have great qualities that not everyone has. They are highly compassionate, caring, professional, diligent and understanding individuals. A nurse experiences people at their worst and still care for patients in a way that no one else would. All these honest points prove that nurses are the most important members of the health care system because, nurses spend the most time with patients, nurses are the managers of patient care; they are teachers and are great with conflict resolution.

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.