Sustaining a Standardized Cardiac Monitor Care Process to Reduce Nuisance Alarms

Abstract

Act (PDSA) testing we created a standardized ADL process that involved all providers. Interventions included addressing 1-2-3 compliance during rounds, creating accountability in care delivery, creation of an algorithm and order set for oral care, daily text message reminders, and physician intervention with non-compliant and high-risk patients. Findings & Interpretation: Our baseline compliance with the 1-2-3 initiative was 25%. With our interventions we increased our median compliance to 66% in 90 days. The greatest impact on compliance was seen with text message reminders to staff to complete the 1-2-3 components, designated roles and responsibilities, and physician discussion with noncompliant and high-risk patients. Discussion & Implications: Oral care algorithm and order set, daily text message reminders, and physician intervention with non-compliant and high-risk patients could all be adaptive to other units. Units where compliance with ADL participation is low would be an ideal environment to incorporate the ADL 1-2-3 initiative.