Clinical alarms were designed with the best of intentions—to alert clinicians about patient emergencies or changes in patient conditions. Most bedside medical devices, such as monitors, infusion pumps and ventilators, are alarm-equipped, but the lack of interoperability among these devices means multiple noises per patient room. Depending on the hospital unit, the number of clinical alerts per patient per day can result in thousands of alarm signals on every unit and tens of thousands throughout the hospital. The inevitable result? Alarm fatigue. The American Association of Critical-Care Nurses (AACN) defines alarm fatigue as “sensory overload when clinicians are exposed to an excessive number of alarms, which can result in desensitization to alarms and missed alarms.”
Hospitals are noisy environments—just ask any nurse how many bells, whistles and alarms they hear during a 12-hour shift. Depending on the hospital unit, the number of alarms per patient per day can reach several hundred, resulting in thousands of alarm signals on every unit and tens of thousands throughout the hospital every day, according to the Joint Commission.
Hospitals are anything but quiet. The whish of automatic doors, squeaking carts, chatter in the hallways, and televisions blaring in the room next door can be a nuisance for someone enduring a hospital stay. Add to that the cacophony of bells, beeps and chimes from bedside machines and patient monitoring devices, and it’s no surprise that noise is the top complaint of patients, visitors and employees on HCAHPS surveys.
Alarm fatigue can lead to medical errors and an unsafe hospital culture, according to a recent medical informatics study. But that’s not all: A less considered, but still valid pain point of unremitting and useless clinical alerts, is an overworked, dissatisfied staff.
The proliferation of alarms on patient monitoring devices is one of the biggest patient safety challenges hospitals face. Though alarms provide clinicians with valuable insight into the status and health of their patients, the incessant noise can overwhelm them and desensitize them to alerts, causing the alarm fatigue plaguing many hospitals.
With the rising number of patient monitors and medical devices on the healthcare market, hospitals are seeing a growing need for platforms that can acquire, filter and manage alarm and event data from devices in a patient’s room and deliver it to the right care team member at the right time.
Spend time in any ICU, and you can’t miss the alarms. The blaring, incessant beeps that randomly erupt from machines around the bedside are startling at first, but the noise is so constant it eventually becomes part of the background.
Alarm fatigue has gotten a lot of press over the past few years, but it’s not the only dangerous alarm-related issue facing hospitals. A lesser-known condition is finally getting some much needed attention. It’s called “auditory masking,” and like its cousin, alarm fatigue, it threatens the safety of patients and the sanity of the nursing teams who care for them.
Last week, HealthLeaders Senior Nursing Editor Jennifer Thew published an article on The Joint Commission’s call for improvements in clinical alarm safety and the role device manufacturers play in helping to mitigate alarm fatigue on nurse teams-- and its ensuing effects on patient safety.
As Thew pointed out, 98 alarm-related sentinel events, 80 of which resulted in death, were reported to The Joint Commission between 2009 and 2012. This, along with surprising patient falls statistics, led The Joint Commission to add clinical alarm safety to its list of national patient safety goals. Earlier this year, that goal entered Phase Two—implementation—and hospitals now need to create policies and procedures to improve clinical alarm safety and protocols.
Imagine your home security system sounding an alarm at random intervals – and often for no urgent reason. If you are employed at a hospital, this probably sounds like just another day at work, except that lives are on the line in your workplace.
Topics: Alarm Management