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"Alarm Fatigue"

Stephanie Chen, Sonali Palchaudhuri, Amber Johnson, Jeff Trost, Ileana Ponor, Sammy Zakaria
INTRODUCTION: The American Heart Association and Choosing Wisely campaign recommend guideline-based usage of telemetry. Inappropriate use leads to increased costs, alarm fatigue, and inefficient nursing care. This study assesses provider ordering practices for telemetry at a US-based academic hospital. METHODS: This retrospective study includes all telemetry orders in the medicine and progressive care units from April 2014 to March 2015. Indications were grouped into categories per American Heart Association guidelines...
January 27, 2017: Journal of Evaluation in Clinical Practice
Matt MacMurchy, Shannon Stemler, Mimi Zander, Christopher P Bonafide
No abstract text is available yet for this article.
January 2017: Biomedical Instrumentation & Technology
Jorge Arroyo-Palacios, Xiao Hu, Yong Bai, Andrea Villaroman, Michele Pelter, Richard Fidler
No abstract text is available yet for this article.
November 2016: Journal of Electrocardiology
Emalie M Petersen, Cindy L Costanzo
BACKGROUND: Excessive clinical alarms have inundated health care for years. Multiple governing bodies, organizations, and facilities have deemed alarm management a priority. Alarm management is a multifaceted problem that affects all health care organizations and clinical staff, especially those in critical care units. Ultimately, the lack of knowledge regarding nurses' perceptions to alarm management and alarm fatigue creates patient safety chiasms. OBJECTIVES: The purpose of this quality improvement project was to understand nurses' perceptions of alarm fatigue (utilizing the Healthcare Technology Foundation's Clinical Alarms Committee Survey) while implementing interventions that improve patient safety...
January 2017: Dimensions of Critical Care Nursing: DCCN
Marjorie Funk, Halley Ruppel, Nancy Blake, JoAnne Phillips
Monitor watchers, or personnel whose job it is to watch the central cardiac monitor and alert clinicians of patient events, are used in many hospitals. Monitor watchers may be used to improve timely response to alarms and combat the effects of alarm fatigue. However, little research has been done on the use of monitor watchers, and their practices have not been well described. Therefore, the purpose of our study was to examine the use of monitor watchers and their characteristics, training, and practices. Participants were recruited to complete an online survey on monitor watcher practice via two professional nursing organizations...
November 2016: Biomedical Instrumentation & Technology
Emma Kurnat-Thoma, Kayuri Shah
BACKGROUND: The Joint Commission's 2014 National Patient Safety Goals required hospitals to evaluate alarm safety in 2014-2015 and implement alarm safety policies. OBJECTIVE: The aim of this study was to assess common alarm management safety factors in our 187-bed community hospital. METHODS: Two weeks' worth of IV pump report data was evaluated to characterize 33 IV pump alarm types. Hospital and IV pump noise was measured, and an alarm management nurse survey was conducted...
December 2016: Journal of Nursing Administration
Camellia Torabizadeh, Amirhossein Yousefinya, Farid Zand, Mahnaz Rakhshan, Mohammad Fararooei
Alarm fatigue can adversely affect nurses' efficiency and concentration on their tasks, which is a threat to patients' safety. The purpose of the present study was to develop and test the psychometric accuracy of an alarm fatigue questionnaire for nurses. This study was conducted in two stages: in stage one, in order to establish the different aspects of the concept of alarm fatigue, the researchers reviewed the available literature-articles and books-on alarm fatigue, and then consulted several experts in a meeting to define alarm fatigue and develop statements for the questionnaire...
November 15, 2016: Journal of Clinical Monitoring and Computing
Leo Kobayashi, John W Gosbee, Derek L Merck
OBJECTIVES: (1) To develop a clinical microsystem simulation methodology for alarm fatigue research with a human factors engineering (HFE) assessment framework and (2) to explore its application to the comparative examination of different approaches to patient monitoring and provider notification. BACKGROUND: Problems with the design, implementation, and real-world use of patient monitoring systems result in alarm fatigue. A multidisciplinary team is developing an open-source tool kit to promote bedside informatics research and mitigate alarm fatigue...
November 3, 2016: HERD
Michele M Pelter, Richard Fidler, Xiao Hu
BACKGROUND: Although electrocardiographic monitoring is valuable for continuous surveillance of intensive care unit (ICU) patients, false alarms are common and have been cited as a cause of alarm fatigue. ANSI/AAMI EC12:2002 states that electrocardiograms (ECGs) should not detect a QRS if the waveform is less than 0.15 mV (1.5 mm) for adult patients, in order to avoid mislabeling P waves or baseline noise as QRSs during complete heart block or asystole. However, ECG software algorithms often use more conservative QRS thresholds, which may result in false-positive asystole alarms in patients with low-amplitude QRS complexes...
September 2016: Biomedical Instrumentation & Technology
Mohamed Abdelazez, Patrick Quesnel, Adrian Chan, Homer Yang
: The objective of this study is to propose and validate an alarm gating system for a myocardial ischemia monitoring system that uses ambulatory electrocardiogram (AECG). The PeriOperative ISchemic Evaluation (POISE) study recommended the selective administration of β blockers to patients at risk of cardiac events following non-cardiac surgery. Patients at risk are identified by monitoring ST-segment deviations in the electrocardiogram (ECG); however, patients are encouraged to ambulate to improve recovery, which deteriorates the signal quality of the ECG leading to false alarms...
August 25, 2016: IEEE Transactions on Bio-medical Engineering
Scott B Hu, Deborah J L Wong, Aditi Correa, Ning Li, Jane C Deng
INTRODUCTION: Clinical deterioration (ICU transfer and cardiac arrest) occurs during approximately 5-10% of hospital admissions. Existing prediction models have a high false positive rate, leading to multiple false alarms and alarm fatigue. We used routine vital signs and laboratory values obtained from the electronic medical record (EMR) along with a machine learning algorithm called a neural network to develop a prediction model that would increase the predictive accuracy and decrease false alarm rates...
2016: PloS One
Jacob W Turmell, Lola Coke, Rachel Catinella, Tracy Hosford, Amy Majeski
The purpose of this article is to describe the impact of an evidence-based alarm management strategy on patient safety. An alarm management program reduced alarms up to 30%. Evaluation of patients on continuous cardiac monitoring showed a 3.5% decrease in census. This alarm management strategy has the potential to save $136 500 and 841 hours of registered nurses' time per year. No patient harm occurred during the 2-year project.
January 2017: Journal of Nursing Care Quality
Veena V Goel, Sarah F Poole, Christopher A Longhurst, Terry S Platchek, Natalie M Pageler, Paul J Sharek, Jonathan P Palma
INTRODUCTION: Modification of alarm limits is one approach to mitigating alarm fatigue. We aimed to create and validate heart rate (HR) and respiratory rate (RR) percentiles for hospitalized children, and analyze the safety of replacing current vital sign reference ranges with proposed data-driven, age-stratified 5th and 95th percentile values. METHODS: In this retrospective cross-sectional study, nurse-charted HR and RR data from a training set of 7202 hospitalized children were used to develop percentile tables...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
George W Williams, Christy A George, Brian C Harvey, Jenny E Freeman
BACKGROUND: Current respiratory monitoring technologies such as pulse oximetry and capnography have been insufficient to identify early signs of respiratory compromise in nonintubated patients. Pulse oximetry, when used appropriately, will alert the caregiver to an episode of dangerous hypoxemia. However, desaturation lags significantly behind hypoventilation and alarm fatigue due to false alarms poses an additional problem. Capnography, which measures end-tidal CO2 (EtCO2) and respiratory rate (RR), has not been universally used for nonintubated patients for multiple reasons, including the inability to reliably relate EtCO2 to the level of impending respiratory compromise and lack of patient compliance...
January 2017: Anesthesia and Analgesia
Susan P McGrath, Andreas H Taenzer, Nancy Karon, George Blike
BACKGROUND: The growing number of monitoring devices, combined with suboptimal patient monitoring and alarm management strategies, has increased "alarm fatigue," which have led to serious consequences. Most reported alarm man- agement approaches have focused on the critical care setting. Since 2007 Dartmouth-Hitchcock (Lebanon, New Hamp- shire) has developed a generalizable and effective design, implementation, and performance evaluation approach to alarm systems for continuous monitoring in general care settings (that is, patient surveillance monitoring)...
July 2016: Joint Commission Journal on Quality and Patient Safety
Michael F Rayo, Susan D Moffatt-Bruce
No abstract text is available yet for this article.
July 2016: Joint Commission Journal on Quality and Patient Safety
Krystal Lansdowne, David G Strauss, Christopher G Scully
BACKGROUND: The cacophony of alerts and alarms in a hospital produced by medical devices results in alarm fatigue. The pulse oximeter is one of the most common sources of alarms. One of the ways to reduce alarm rates is to adjust alarm settings at the bedside. This study is aimed to retrospectively examine individual pulse oximeter alarm settings on alarm rates and inter- and intra- patient variability. METHODS: Nine hundred sixty-two previously collected intensive care unit (ICU) patient records were obtained from the Multiparameter Intelligent Monitoring in Intensive Care II Database (Beth Israel Deaconess Medical Center, Boston, MA)...
2016: BMC Nursing
Azizeh Khaled Sowan, Tiffany Michelle Gomez, Albert Fajardo Tarriela, Charles Calhoun Reed, Bruce Michael Paper
BACKGROUND: Clinical alarm systems safety is a national concern, specifically in intensive care units (ICUs) where alarm rates are known to be the highest. Interventional projects that examined the effect of changing default alarm settings on overall alarm rate and on clinicians' attitudes and practices toward clinical alarms and alarm fatigue are scarce. OBJECTIVE: To examine if (1) a change in default alarm settings of the cardiac monitors and (2) in-service nursing education on cardiac monitor use in an ICU would result in reducing alarm rate and in improving nurses' attitudes and practices toward clinical alarms...
2016: JMIR Human Factors
Rohan Joshi, Carola van Pul, Louis Atallah, Loe Feijs, Sabine Van Huffel, Peter Andriessen
Patient monitoring generates a large number of alarms, the vast majority of which are false. Excessive non-actionable medical alarms lead to alarm fatigue, a well-recognized patient safety issue. While multiple approaches to reduce alarm fatigue have been explored, patterns in alarming and inter-alarm relationships, as they manifest in the clinical workspace, are largely a black-box and hamper research efforts towards reducing alarms. The aim of this study is to detect opportunities to safely reduce alarm pressure, by developing techniques to identify, capture and visualize patterns in alarms...
April 2016: Physiological Measurement
Amanda C Schondelmeyer, Patrick W Brady, Heidi Sucharew, Guixia Huang, Kelsey E Hofacer, Jeffrey M Simmons
BACKGROUND: Concerns about alarm fatigue prompted The Joint Commission to issue a Sentinel Event Alert urging hospitals to minimize alarms. We previously conducted a quality improvement project on a single unit that reduced time on continuous pulse oximetry, a common source of physiologic monitor alarms, for patients with wheezing (ie, asthma and bronchiolitis, wheezing-associated respiratory infections). OBJECTIVE: To study the impact of our improvement work on overall physiologic monitor alarm frequency for these patients...
April 2016: Hospital Pediatrics
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