Technological Distractions (Part 2): A Summary of Approaches to Manage Clinical Alarms With Intent to Reduce Alarm Fatigue

Winters, Bradford D.; Cvach, Maria; Bonafide, Christopher P.; Hu, Xiao; Konkani, Avinash; OʼConnor, Michael; Rothschild, Jeffrey M.; Selby, Nicholas M.; Pelter, Michele M.; McLean, Barbara; Kane‐Gill, Sandra L.

doi:10.1097/ccm.0000000000002803

Cited by 136 publications

(71 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A primary strategy that is proposed to tackle alarm fatigue is the reduction of unnecessary alarms [20]. Based upon our findings, making arrhythmia alarms inaudible seems to be a reasonable first step during EOL care.…”

Section: Discussionmentioning

confidence: 72%

ECG Monitoring during End of Life Care: Implications on Alarm Fatigue

Suba

Sandoval²,

et al. 2019

MTI

Self Cite

View full text Add to dashboard Cite

Excessive numbers of clinical alarms in the intensive care unit (ICU) contribute to alarm fatigue. Efforts to eliminate unnecessary alarms, including during end of life (EOL) care, are pivotal. This study describes electrocardiographic (ECG) arrhythmia alarm usage following the decision for comfort care. We conducted a review of electronic health records (EHR) in patients who died and had comfort care orders that were in place during our study. The occurrences of ECG arrhythmia alarms among these patients were examined. We found 151 arrhythmia alarms that were generated in 11 patients after comfort care was initiated: 72% were audible, 21% were manually muted, and 7% had an unknown audio label. Level of alarm: 33% crisis, 58% warning, 1% message, and 8% were labeled unknown. Our report shows that ECG monitoring was commonly maintained during the EOL care. Since the goal of care during this phase is for both patient and family comfort, it is important for the clinicians to weigh the benefits versus harms of the continuous ECG monitoring.

show abstract

Section: Discussionmentioning

confidence: 72%

ECG Monitoring during End of Life Care: Implications on Alarm Fatigue

Suba

Sandoval²,

et al. 2019

MTI

Self Cite

View full text Add to dashboard Cite

show abstract

“…More recently, a systematic review sought to find interventions that have been successfully used to reduce alarm fatigue. Changes in pre-defined settings of alarms due to patients' needs, daily electrode changes, rounds on clinical alarms, and team education in the use of the technologies were pointed out as successful interventions, although the study did not demonstrate a single strategy solution to the problem but an integration of multiple strategies with synergistic benefits (18) .…”

Section: Discussionmentioning

confidence: 97%

Individualized parameterization of multiparametric monitors alarms in infarcted patients

et al. 2019

View full text Add to dashboard Cite

Objective: To measure the magnitude of the effect of an individualized parameterization protocol for hemodynamic alarms in patients with acute myocardial infarction. Method: Pragmatic clinical trial, open label and single arm, whose intervention was performed through a protocol validated and tested in 32 patients using multiparametric monitors. The heart rate, blood pressure, respiratory rate, oxygen saturation and ST segment-monitoring were measured and classified for clinical consistency one hour before and after the intervention, for 64 hours. Results: The protocol obtained Content Validity Index of 0.92. Of the 460 registered alarms, 261 were considered inconsistent before the intervention and 47 after it. The Relative Risk of inconsistent alarms after the protocol was 0.32 (95% CI 0.23-0.43, p <0.0001). Conclusion: The protocol proved to be a protective factor to the appearance of inconsistent clinical alarms of multiparametric monitors.

show abstract

“…25 Alarm fatiguedassociated with delayed/no response to alarmsdresults from desensitization due to increased exposure to alarms, especially to nonactionable or false alarms. 26 Combined measures of customizing alarm parameters and displays, introducing notification systems with better algorithms, changing batteries, electrodes, and sensors regularly, and careful attention to practice change have all been documented as key strategies for reducing the number of alarms from 18.5% to 89.0%. 25,26 Winters et al argue that decreasing the number, duration, and noise level of alarms is a top priority for RAM implementation to improve satisfaction among front-line nurses.…”

Section: Connectivity and Alarm Fatiguementioning

confidence: 99%

“…25,26 Winters et al argue that decreasing the number, duration, and noise level of alarms is a top priority for RAM implementation to improve satisfaction among front-line nurses. 26…”

Section: Connectivity and Alarm Fatiguementioning

confidence: 99%

Postoperative Remote Automated Monitoring: Need for and State of the Science

McGillion

Duceppe

Allan

et al. 2018

Canadian Journal of Cardiology

View full text Add to dashboard Cite

Worldwide, more than 230 million adults have major noncardiac surgery each year. Although surgery can improve quality and duration of life, it can also precipitate major complications. Moreover, a substantial proportion of deaths occur after discharge. Current systems for monitoring patients postoperatively, on surgical wards and after transition to home, are inadequate. On the surgical ward, vital signs evaluation usually occurs only every 4-8 hours. Reduced in-hospital ward monitoring, followed by no vital signs monitoring at home, leads to thousands of cases of undetected/delayed detection of hemodynamic compromise. In this article we review work to date on postoperative remote automated monitoring on surgical wards and strategy for advancing this field. Key considerations for overcoming current barriers to implementing remote automated monitoring in Canada are also presented.

show abstract

Technological Distractions (Part 2): A Summary of Approaches to Manage Clinical Alarms With Intent to Reduce Alarm Fatigue

Cited by 136 publications

References 65 publications

ECG Monitoring during End of Life Care: Implications on Alarm Fatigue

ECG Monitoring during End of Life Care: Implications on Alarm Fatigue

Individualized parameterization of multiparametric monitors alarms in infarcted patients

Postoperative Remote Automated Monitoring: Need for and State of the Science

Contact Info

Product

Resources

About