Importance of Alarm Fatigue

1. Importance of Alarm Fatigue By: Jessica Odom

2. Objectives Participants will be comprehend the history and background associated with alarm fatigue Participants will understand the importance of continuous alarms and the impact it has on patient safety. Participants will verbally communicate strategies to prevent constant false alarms. Participants will gain insight into future implications about alarm fatigue.

3. Introduction Alarm fatigue is defined as “the lack of response due to excessive numbers of alarms resulting in sensory overload and desensitization, is a national problem.” Alarms have been labeled as the number one health technology hazard for 2012. False or clinically insignificant alarms range from 80-99%. The problem will excessive alarms have been studied for over the past 20 years. Goal: technology aims to decrease false positive alarms and increase positive predictive value.

4. Problem/ Challenge Frequent alarms are distracting and interfere with healthcare providers performing tasks, therefore people disable the alarming system or HCPs become desensitization. Alarm fatigue creates a false sense of security regarding patient safety. Its researched that nurses are more likely to respond to a longer duration high priority alarms because they are more urgent. The noise level in hospitals exceed the (WHO) recommended level, alarms being the main contributing factor. Currently, there are no standards for setting default alarm parameters of alarms related to urgency. Hospitals need to develop alarm setting and response protocols. Different manufacturers have different alarm sounds, currently there is no requirement for vendors to have uniform alarms. HCPs silence alarms and sometimes silence multiple alarms without realizing it.

5. Recommendations • “Smart alarms” are recommended because they take into account multiple parameters, rate of change, and signal quality to reduce false alarms. • Staff should be trained initially and continuously on alarm-based medical devices to understand meaning of each alarm and proper way to inactive them. • To minimize nuisance alarms: • Prepare skin before placing (ECG) electrodes; cut away excessive hair, clean dirty or diaphoretic skin, • Replace (ECG) electrodes and pulse oximeter daily after patient’s bath. • Ensure proper placement of electrodes. • Customizing alarm parameters to the actual patient’s need ensures that the alarms are valid. Documenting alarm parameters in the medical record is an effective intervention. • Educate staff on customizing alarm settings. • Get doctors input on customizing patient’s alarm setting and understand when the doctors want to be notified to improve alarm specificity.

6. Future Implications A vide variety of technology is being explored to reduce alarm fatigue in the future. Video equipped patient monitoring offers and interactive component that allows HCPs to identify and act upon patient problems from a remote point. Incorporating this type of technology into patient homes in the future is under investigation and experiment. Robotics may become the future for alarm management as we move into the future.

7. Reference Cvach, M. (2012). Monitor alarm fatigue. Biomedical Instrumentation & Technology, 268-277. Cvach, M., Dang, D., Foster, J., Irechukwu, J. (2009). Clinical alarms and the impact on patient safety. Initiatives, 1-8. Kreimer,S. (2013). Alarming: joint commission, FDA set to tackle alert fatigue. H&HN, 18-19.