Nurses? reactions to alarms in a neonatal intensive care unit

Bitan, Yuval; Meyer, Joachim; Shinar, David; Zmora, Ehud

doi:10.1007/s10111-004-0162-2

Cited by 76 publications

(49 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Because of the number of nuisance alarm signals, care providers can experience a "cry wolf " effect, leading to desensitization and alarm system mistrust, so that real events are less likely to be acted on. [33][34][35] Eventually, this situation has led staff to begin to mistrust the alarm system so that real events are less likely to be acted on. [33][34][35][36] has termed this the "false-alarm effect" and has posited that the more sensitive a warning system is, the greater is the effect from repeated false alarms because weaker signals will be detected, thus creating more alarm signals.…”

Section: Discussionmentioning

confidence: 99%

“…[33][34][35] Eventually, this situation has led staff to begin to mistrust the alarm system so that real events are less likely to be acted on. [33][34][35][36] has termed this the "false-alarm effect" and has posited that the more sensitive a warning system is, the greater is the effect from repeated false alarms because weaker signals will be detected, thus creating more alarm signals. This issue of sensitivity may have been part of the reason for the results in a recently published study, 37 which demonstrated that, of 17 "crisis level" alarms that occurred, 16 were ventricular tachycardia alarms, 9 were for artifacts, and none of the alarm signals was for a true ventricular tachycardia.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Stop the Noise: A Quality Improvement Project to Decrease Electrocardiographic Nuisance Alarms

Sendelbach

Wahl

Anthony

et al. 2015

Critical Care Nurse

View full text Add to dashboard Cite

BACKGROUND As many as 99% of alarm signals may not need any intervention and can result in patients’ deaths. Alarm management is now a Joint Commission National Patient Safety Goal. OBJECTIVES To reduce the number of nuisance electrocardiographic alarm signals in adult patients on the medical cardiovascular care unit. METHODS A quality improvement process was used that included eliminating duplicative alarms, customizing alarms, changing electrocardiography electrodes daily, standardizing skin preparation, and using disposable electrocardiography leads. RESULTS In the cardiovascular care unit, the mean number of electrocardiographic alarm signals per day decreased from 28.5 (baseline) to 3.29, an 88.5% reduction. CONCLUSION Use of a bundled approach to managing alarm signals decreased the mean number of alarm signals in a cardiovascular care unit. (Critical Care Nurse. 2015;35[4]:15–23)

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Stop the Noise: A Quality Improvement Project to Decrease Electrocardiographic Nuisance Alarms

Sendelbach

Wahl

Anthony

et al. 2015

Critical Care Nurse

View full text Add to dashboard Cite

show abstract

“…16 In 2004, a study found that nurses did not seem to respond immediately on hearing the alarm, but they recorded the occurrence, assessed the urgency of the problem and eventually acted to remedy it during daily activities 18 . This sense can be justified because 10% of the professionals had no visible conduit to move to the box of the patient; they could indeed be observing and evaluating the patient if the alarm that sounded had represented the clinical condition of the same.…”

Section: Conduct Demanded By Alarmsmentioning

confidence: 99%

Alarm of monitoring invasive of blood pressure: are we giving the attention required?

Pergher¹,

Silva

2015

R. pesq. cuid. fundam. online

View full text Add to dashboard Cite

Objective: To identify the cause of the invasive blood pressure alarms (PAI) have sounded and the staff response time; to describe the conduct set out to address them. Method: Descriptive study of quantitative/qualitative approach. The observation occurred in an adult ICU of a military hospital in Rio de Janeiro. The Research Ethics Committee of the Federal University of Rio de Janeiro (CAAE 03284612.4.3001.5250) approved it. We considered as fatigued the alarms that had not been attended in 10 minutes or stop pedringing before they are attended. Results: Were corded 76-PAI alarms; 21 (28%) were seen on average at 2.45 min. 55 (72%) were considered alarms fatigued. Conclusion: The high number of outworn alarms that represent risk. It is a challenge to respond to all alarms considering the relation between the nurse/patient imposed by ANVISA

show abstract

“…In recent large controlled trials, the median SpO2 was often outside the intended target range [3,4,5,7]. Many studies have also documented serious problems with staff compliance with unit policy in SpO2 targeting [10,11,12,13]. While some have suggested benefits of not aggressively adjusting FiO2 [1,14,15] there is a paucity of literature describing or evaluating protocol driven FiO2-titration strategies.…”

Section: Introductionmentioning

confidence: 99%

Quicker response results in better SpO2 control – a comparison of 3 FiO2-titration strategies in ventilated preterm infants

Wilińska¹,

Bachman²,

Swietliński³

et al. 2015

Ann Agric Environ Med.

View full text Add to dashboard Cite

Quicker response results in better SpO2 control -a comparison of 3 FiO2-titration strategies in ventilated preterm infants. Ann Agric Environ Med. 2015; 22(4): 708-712. doi: 10.5604/12321966.1185781 Abstract Introduction. The impact of SpO2 target ranges (TR) has been carefully studied; however, reports suggest a wide variation among infants and centres in maintaining the intended range. Little is known about the effectiveness of different approaches to manual control. Auto-SpO2 controllers are now available which show promise. Objective. The aim was to compare two different protocol-driven manual strategies with different response requirements to each other, and a faster automated system (AveaCLiO2, Yorba Linda, CA, USA). Materials and methods. In a crossover design, each of the three FiO2/SpO2 approaches was implemented in three randomly assigned consecutive 2.5-hour runs. The two manual strategies (Attentive and Observational) were implemented by a trained operator. The primary endpoints were time in 1) SpO2 TR, 2) < 80% SpO2 and 3) >98% SpO2. Results. Fifteen studies were completed. All three approaches resulted in good control, with time in the target range >60%. CLiO2 use reflected reduced exposure at the two SpO2 extremes. Post hoc analysis determined that the differences were more marked in the infants with more frequent desaturations. Likewise, in this group, the Attentive strategy performed better than the Observative. Conclusions. All three approaches provided excellent control of SpO2 in infants with infrequent desaturations, significantly better than typical routine care. In hard to manage infants with frequent desaturations, faster response appeared to result in better control. The potential of automating the tedious error prone FiO2 adjustment offers significant promise. If manual titration of FiO2 is to remain the usual method of care, additional studies are needed to identify optimal approaches.

show abstract

Nurses? reactions to alarms in a neonatal intensive care unit

Cited by 76 publications

References 22 publications

Stop the Noise: A Quality Improvement Project to Decrease Electrocardiographic Nuisance Alarms

Stop the Noise: A Quality Improvement Project to Decrease Electrocardiographic Nuisance Alarms

Alarm of monitoring invasive of blood pressure: are we giving the attention required?

Quicker response results in better SpO2 control – a comparison of 3 FiO2-titration strategies in ventilated preterm infants

Contact Info

Product

Resources

About