Smarter Alarm Management Fights Alarm Fatigue

Jeanne J. Venella, DNP, MS, RN, CEN, CPEN

Disclosures

January 28, 2016

In This Article

Alarm Management Goes Into High Gear

"The failure to recognize and respond to actionable clinical alarms... in a timely manner" was the second highest-ranked patient safety risk identified in the ECRI Institute's Top 10 Health Technology Hazards for 2016.[1] These threats include actionable alarms that are not detected, as well as alarms that are not handled appropriately by clinical staff owing to miscommunication and alarm fatigue.

The lack of hospital-wide clinical alarm management policies and procedures, and the dangers inherent to alarm mismanagement, achieved prominence in 2013 with the release of the Joint Commission's National Patient Safety Goals on clinical alarm safety.[2] This initiative mandates that hospitals must identify and prioritize alarms based on internal considerations by January 1, 2016. In phase 2, which also begins in January, "hospitals will be expected to develop and implement specific components of policies and procedures. Education of those in the organization about alarm system management will also be required."[2]

Although hospitals and health systems have made progress in solutions development, missed alarms resulting from poor communication or alarm fatigue continue to pose clear and present threats to patient safety. The increase in the number of medical devices with alarm capabilities has only exacerbated the problem, as has the lack of standards on the proper configuration of alarm parameters.

Technology will play a critical role in getting alarms under control, but it is not enough. Without input from the workforce, technology solutions can fail owing to lack of adoption. Nurses and nursing leaders must get out ahead of this issue or solutions will not have representation from the correct stakeholders. Clinical and information technology (IT) leadership, including nurses, respiratory therapists (RTs), biomedical engineers, and IT staff, must come together to develop the policies and standards necessary to prioritize and reduce the number of alarms, as well as to establish protocols for altering current or default alarm parameters.

This article describes how two different hospitals achieved their alarm management goals using both technology and interdisciplinary expertise.

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