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Alarm fatigue

Victor E Ezeugwu, Neera Garga, Patricia J Manns
PURPOSE: Understanding the determinants of sedentary behaviour (sitting or lying with low energy expenditure) in stroke survivors can enhance the development of successful behaviour change strategies. This qualitative study explored the perceptions of stroke survivors about sedentary behaviour and ways in which it can be changed. METHODS: An interpretative qualitative inquiry was used with thematic analysis of interview data. Interviews were conducted using a semi-structured guide with 13 stroke survivors...
October 19, 2016: Disability and Rehabilitation
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
Steven A Kahn, Tina L Palmieri, Soman Sen, Jason Woods, Oliver L Gunter
Firefighting is wrought with risk, as 80-100 firefighters (FFs) died on the job each year in the United States. Many of the fatalities have been analyzed by the National Institute for Occupational Safety and Health (NIOSH) to determine contributing factors. The purpose of this study is to determine variables that put FFs at risk for potentially preventable workplace mortality such as use of personal protective equipment (PPE), seat belts, and appropriate training/fitness/clearance for duty. The NIOSH FF Fatality Database reports from 2009 to 2014 were analyzed...
August 26, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
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
Stephen J Guastello, Katherine E Reiter, Matthew Malon
The effects of workload, fatigue, and practice on the performance of cognitive tasks are often intertwined. Previous research has shown that these influences can be separated with the two cusp catastrophe models. This study expanded an earlier investigation of the two models for workload and fatigue in a vigilance task to include a wider range of bifurcation variables that could affect the elasticity versus rigidity of the operator in response to workload and added performance variability resulting from fatigue...
October 2016: Nonlinear Dynamics, Psychology, and Life Sciences
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.
August 5, 2016: Journal of Nursing Care Quality
Linda M Eerikäinen, Joaquin Vanschoren, Michael J Rooijakkers, Rik Vullings, Ronald M Aarts
In this paper, we propose an algorithm that classifies whether a generated cardiac arrhythmia alarm is true or false. The large number of false alarms in intensive care is a severe issue. The noise peaks caused by alarms can be high and in a noisy environment nurses can experience stress and fatigue. In addition, patient safety is compromised because reaction time of the caregivers to true alarms is reduced. The data for the algorithm development consisted of records of electrocardiogram (ECG), arterial blood pressure, and photoplethysmogram signals in which an alarm for either asystole, extreme bradycardia, extreme tachycardia, ventricular fibrillation or flutter, or ventricular tachycardia occurs...
August 2016: Physiological Measurement
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...
July 14, 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...
July 5, 2016: Anesthesia and Analgesia
Stephen J Gleich, Kim Strupp, Robert T Wilder, Daryl J Kor, Randall Flick
BACKGROUND: Malignant hyperthermia (MH) is a rare anesthetic pharmacogenetic disorder that can be difficult to detect in its earliest phases. Prompt treatment is known to improve outcomes. The modern anesthesia information management systems (AIMS) collect enormous amounts of data. However, data lack context and are not able to provide real-time guidance. Utilizing our AIMS, we developed the capacity to incorporate decision support. AIMS: We describe the creation and evaluation of a real-time detection tool for MH...
September 2016: Paediatric Anaesthesia
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
Kun Yang, Manuela Perez, Gabriela Hossu, Nicolas Hubert, Cyril Perrenot, Jacques Hubert
BACKGROUND: In robotic surgery, the professional ergonomic habit of using an armrest reduces operator fatigue and increases the precision of motion. We designed and validated a pressure surveillance system (PSS) based on force sensors to investigate armrest use. The objective was to evaluate whether adding an alarm to the PSS system could shorten ergonomic training and improve performance. STUDY DESIGN: Twenty robot and simulator-naïve participants were recruited and randomized in two groups (A and B)...
May 17, 2016: Surgical Endoscopy
James J MacNeal, David C Cone, Christopher L Wistrom
A number of long-term health effects are suffered by emergency responders, some influenced by psychological stress and fatigue. This study explored if stress and fatigue can be reduced by changing the method by which firefighters are alerted to emergency responses. Over several months, the method by which responders at a fire department were alerted was altered. Firefighter heart rates were measured first with standard alerting as a control (phase 1: all stations alerted simultaneously, with high-volume tones)...
November 2016: Journal of Occupational and Environmental Hygiene
Mary Jahrsdoerfer
No abstract text is available yet for this article.
March 2016: Biomedical Instrumentation & Technology
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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