Waking up to alarm fatigue

Hospitals turn down volume on audio distractions

Technology is most often a benefit in health care. But sometimes it can be too much of a good thing.Fatigue

Take the proliferation of medical devices that have alarms. Among the alarm-equipped devices that may be at a bedside are electrocardiogram machines, pulse oximetry devices, blood pressure monitors, central station monitors, infusion pumps, ventilators and many more.

These devices are critical to the provision of safe care, and clinicians rely on them for accurate information. Yet sometimes the alarms that are intended to alert staff to a problem instead cause a problem, called alarm fatigue.

The Joint Commission estimates that tens of thousands of alarm signals go off in the average hospital each day, sometimes hundreds for a single patient. “The patient safety ramifications of this proliferation are so important that the Joint Commission has singled out alarm fatigue as a national patient safety goal for 2014,” said Diane Hanley, MSN, RNBC, EJD, associate CNO.

At Hallmark Health System, a multidisciplinary committee has been meeting monthly to manage alarm fatigue and has taken a number of actions:
1.  distribution of an alarm safety survey to all clinical staff where all critical alarms were reviewed
2.  development of an inventory of alarmequipped devices – there are more than 100 such devices throughout HHS
3.  establishment of guidelines for settings on these devices, including determining the proper settings and who has the authority to change a setting
4.  development and implementation of mandatory training for telemetry alarm settings for patients requiring cardiac monitoring
5.  inclusion of queries in RMPro reporting regarding equipment and alarms
6.  establishment of a schedule for regular preventive maintenance for alarm equipped devices.

“Alarm fatigue is a serious problem, since our staff can become desensitized to the constant noise of dozens of alarms,” said Hanley. “We are looking for the ‘sweet spot’ where alarms do their job of protecting patient safety without overwhelming staff.”

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