Confronting the Risks and Challenges of Alarm Fatigue
Whether as a patient, family member, or caregiver, we’ve all heard the bells, beeps and chimes emitted by monitors and other equipment necessary for patient care. As a family member, I have been in awe that nurses can distinguish between a routine sound and a more urgent alert, while maintaining quality care. Unfortunately, the prevalence of alarms has increased in recent years, and at times has caused caregivers to become desensitized to them. And many new alerts, such as those broadcast via EHR systems have added to the confusion. Some patient injuries have even been attributed to "alarm fatigue", due to ignored or misunderstood alarms.
In Nov 2014, the ECRI announced its “Top 10 Health Technology Hazards for 2015”[i], and number one for the fourth consecutive year was alarm hazards stemming from inadequate alarm configuration policies and practices. According to the report, “Caregivers rely on medical device alarms to inform them about changes in the patient’s status or circumstances that could adversely affect the patient’s care. When this warning system fails or is ineffective, patients can be harmed—as evidenced by numerous reports of alarm-related deaths and serious injuries.”
To combat this challenge, facilities have been enacting a wide variety of measures to ease the prevalence of alarms and the threat to patient safety that too many alarms can cause. In early 2014, the Joint Commission published its National Patient Safety Goal on Alarm Management[ii] and many resources are available to assist facilities as they improve their alarm management procedures. Some areas being considered include:
- Reviewing response procedures to ensure consistent and appropriate use of devices
- Determining which devices are causing the most frequent alarms and evaluating device settings to ensure optimal programming
- Gathering first-hand information from caregivers to identify areas in which alarms could potentially be reduced
- Developing clear protocols for patient handoff between units to ensure a smooth transition of responsibility
- Building a culture of safety before a sentinel event occurs by reinforcing the relationship between alarm management and patient safety
We welcome your input about what your facility is doing to reduce alarm fatigue and how the vendor community can best support your efforts.