As nurses, we rely on clinical alarm systems to warn us when a patient’s condition changes. These alarms are designed to communicate information that requires a caregiver’s immediate attention, action, or awareness, and they are typically considered to be a key tool in patient safety. When they work as intended, clinical alarms enhance the care environment.
Yet they have a dark side as well. Under certain conditions, clinical alarms might pull nurses away from other more critical duties or patients. Or they might go off so frequently that nurses cannot respond quickly or become conditioned to ignore them – a phenomenon sometimes called alarm fatigue.
According to an AACN practice alert, alarm fatigue has contributed to patient deaths. Research shows anywhere from 80 to 99 percent of ECG monitor alarms are false or clinically insignificant. And the practice alert states that “Although studies show it is difficult for humans to differentiate among more than 6 different alarm sounds, the average number of alarms in an ICU has increased from 6 in 1983 to more than 40 different alarms in 2011.” This type of sensory overload can make it difficult for nurses to respond to alarms appropriately the majority of the time.
The Joint Commission is addressing the problem of alarm fatigue and promoting best practices in managing clinical alarm systems through a new National Patient Safety Goal. Phase I began in January 2014 and required critical access hospitals to make clinical alarms an organizational priority and to begin a quality improvement initiative by identifying the alarms most in need of management, based on their own internal circumstances.
Phase II will begin in January 2016 and will require hospitals to develop and implement specific policies and procedures designed to better manage clinical alarms, and to educate staff members about alarm system management. Hospitals will be expected to examine their own cultures, practices, and technologies in order to improve their use of clinical alarms.
Additionally, leaders in the field of healthcare technology have formed a National Coalition for Alarm Safety & Management, so that hospitals working to improve alarm management are not doing so in isolation. The coalition’s website states: “This coalition brings together stakeholders to share what they have learned, build synergies, and create common ground where all can agree on certain default parameters that should be set, and on other solution strategies to improve alarm management.” The idea is for pioneering hospitals to share information and resources, and perhaps the country toward some level of standardization among alarm management practices (while recognizing that customization will always be necessary for specific units, individual patients, or patient populations.
So what can you do, as a nurse, to contribute to the safer use of clinical alarm systems? If your hospital has a quality improvement initiative in place that focuses on alarm management, you can provide input from the nursing perspective or volunteer for a committee. And as new policies are developed and implemented, you can make a strong effort to understand them and adhere to them, in order to keep patients as safe as possible.
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