Strategies to Reduce Monitor Alarm Fatigue
Courtney Conner
University of South Alabama
Strategies to Reduce Monitor Alarm Fatigue
Monitor alarms are designed to alert caregivers to changes in a patient’s condition and can save lives, but majority of the alarms do not require clinical intervention. However, as the number of alarms encountered by clinicians on a daily basis rises, it has become difficult for caregivers to distinguish between clinically significant alarms and nuisance alarms. As a result, alarm fatigue has become a serious issue, which puts patients at risk. The purpose of this paper is to discuss the research findings of two articles to explore more efficient and effective methods to reduce nurse desensitization to clinical
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The findings found that nurses felt irritated with inappropriate alarm settings and the high volume of noise on unit, resulting in delays in response times. False alarms were the main culprit in the nurses' opinions. The interventions supplied by the article were individualizing alarm limits, buddying systems, a charge nurse making rounds, and the development of smart alarms with algorithms that cover multiple conditions (Christensen et al., 2014). 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.
Level of Evidence and Grade of Recommendation According to the
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)
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
B. Discussion on the process improvement plan that is likely to decrease or eliminate the reoccurrence of the outcome or scenario.
Effective communication is crucial aspect of nursing yet too often is placed low on the priority list, especially at shift change. Information related to the care of patients is frequently disseminated at a crowded, noisy nurse station with several nurses rushing to leave and others attempting to get the information necessary to plan care and limit the constant distractions. It is this interaction that allows for information vital patient safety information to be communicated including the acuity of patients.
Florence Nightingale’s nursing theory is probably the most well known in the nursing profession. “Patients are to be put in the best condition for Nature to act on them. It is the responsibility of nurses to reduce noise, to relieve patients’ anxiety, and to help them sleep” (Theories of Florence Nightingale, 2012). This theory emphasizes that environmental factors and adaptation is the basis of holistic nursing care. This theory is important in my opinion because it ensures that the center of focus is on the patient. When patients are hospitalized making them comfortable in a new and strange environment is important to me. Eliminating noise at the nursing station and turning down the lighting in the hallways at night are just a few ways that nurses can improve the environmental factors surrounding patients. During hospitalizations I strive to eliminate any anxiety that my patient may be experiencing. Upcoming procedures and treatments can cause tremendous stress. Simply by providing sufficient information regarding treatments or procedures can be beneficial in reducing anxiety or
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.
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
The definition of Alarm Fatigue is a situation where people become desensitized to alarms in response to excessive exposure (merriam- webster dictionary). Alarm fatigue also causes attention spans to be lowered which affects Nurses readiness for an emergency on their shift. Alarms can be overwhelming and all alarm alerts are designed differently. In an environment of constant urgency Nurses have even been described as ignoring the alarms or being negligent. There are also many different alarm terms, from false alarms and high sensitivity alarms to nuisance alarms. With so many alarm-related terms it is relevant to ensure proper understanding of these the terms to reduce risky
Horkan, A. M. (2014). Exploring the Evidence Alarm Fatigue and Patient Safety. Nephrology Nursing Journal, 41(1), 83-85.
Unlike physicians who spend approximately 30 to 45 minutes per day with a patient, the presence of nurses at the bedside is essential throughout the day. Apart from attending the patients, they regularly interact with families of the sick and other healthcare practitioners, such as physicians and pharmacists. Given their constant presence at the bedside, nurses play a critical role in maintaining patient safety by continuously observing patients for deterioration or improvement of health. They also help in the detection of medical errors, identification of near misses, and discovery of weaknesses that might be inherent in some systems (“Nursing and Patient Safety,” 2017). Since the role of nurses is crucial to the maintenance of patient safety, it is logical that increasing their workload is bound to adversely affect their ability to deliver quality work and safe services.
Errors pervade in our lives whether it is our home, in our workplace, or in our society. The effects of healthcare errors have impacted all our lives either directly or indirectly. Patient safety and quality care are at the core of healthcare system which strongly depends upon nurses. “To achieve goals in patient safety and quality, thereby improve healthcare, nurses must assume the leadership role. Nurses need to ensure that they and other healthcare providers center healthcare on patients and their families. Even though the quality and safety of healthcare is heavily influenced by the complex nature
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
Stressful work environments, long work hours and inadequate sleep all contribute to an increase in physical and mental exhaustion amongst nurses. Typically, people choose nursing as a career to help others and to make a difference in their lives, without realizing the number of duties this career demands. Nurses may suffer in silence when they are experiencing stress. The effects can impact safe and reliable care by decreasing job satisfaction, decreasing productivity, causing poor personal health, and compromising patient care. Many facilities would benefit from implementing evidence-based strategies to address nurse fatigue and burnout.
One of the many goals of the nursing profession is to provide high-quality, safe patient care. There are many responsibilities that come with a nursing career and when the nurse to patient ratio increases, there is a possibility that it may hinder the safe care that patients deserve, and this may result in negative patient outcomes and level of satisfaction. Staffing is one of the many issues that healthcare facilities face. In many facilities, there never seems to be enough nurses per shift to provide high quality, thorough patient care which often leads to burnt out staff, and frustrated patients and families. This review discusses the findings of quantitative studies and one systematic review that involves patient outcomes in relation to nurse staffing.