Basic HTML Version
14
NOV / DEC 2013
I
Healthcare Journal of NEW ORLEANS
alarm fatigue
management, quality, biomedical engineer-
ing, is to review those processes and update
any policies, as well as develop a new pol-
icy that will standardize and establish some
guidelines for alarm settings,”said Surla. “We
canmonitor those from a quality assurance
perspective moving forward.”
Standardization of parameters will also
help avoid confusion and error when attach-
ing monitors to a new patient, but it is also
important that hospitals determine who has
the authority to adjust those parameters,
disable an alarm, etc. Even this is not fool-
proof. Cases have been noted where a doc-
tor or nurse may go into a room to perform
a task and an alarm starts sounding. They
may turn down the alarm in order to talk
to the patient, with the intent of reporting
the alarm when they leave the room, but
may become distracted. “We have a lot of
alarms that we use for managing patients
just to alert caregivers. But when you have
so many sometimes it gets confusing,” said
Brewer. “There are a lot of issues from a
patient safety perspective. Are they really
paying attention to the alarms, does your
staff really know what the alarms mean?
You make sure you have adequate training
and education on why you have alarms and
what different alarms are for.”
Shelly Welch, Senior Vice President,
Patient Services/Director of Nursing at North
Oaks Medical Center, agreed, “There are so
many alarms in an acute care hospital and
any acute setting, that any time we look at
any kind of newmonitoring systemwe have
to critique what alarms are there, what tones
are there, how they sound, in order to try and
predict how staff is going to respond, and
have staff respond appropriately towhatever
type of alarm it is. Something very simple like
a pump or something critical like an arrhyth-
mia on a heart monitor that’s very different,
so we try to make sure our staff know how
to distinguish that.”
Luckily fewhospitals of any size rely solely
on audible alarms. While these still sound,
some hospitals have added visual cues that
an alarm is sounding either on a light dis-
play outside a patient’s room, on amain bed-
board, or at the nurse’s station. For instance,
A system of lights triggered by
equipment alarms can add a visual
cue to aid in alarm response.
Quality Ruby Brewer. “For someone very fit,
their low limit for heart rate might have to
be set lower than normal so it doesn’t trigger
the alarm. We try to individualize some of
those.” In its Sentinel Alert, the Joint Com-
mission stated that an estimated 85 to 99
percent of alarm signals do not require clini-
cal intervention. Customization of alarms
can go a long way towards reducing mean-
ingless alarms, false positives, and unneces-
sary noise and is a practice encouraged by
the accrediting organization.
“Part of our multi-functional team of
different disciplines that we formed as a
result of this Sentinel Event, nursing, risk
Cindy Johnson
Quality and Risk
Management Director,
Slidell Memorial
Hospital
Shelly Welch
Senior Vice President
Patient Services/
Director of Nursing,
North Oaks Medical
Center
Carol McCullough
Chief Nursing Officer,
Slidell Memorial
Hospital
“When you look at cardiac
monitors and things
like that people are very
unique and one size
doesn’t always fit all.”
alarm photos courtesy Woman’s Hospital