Research Article
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Year 2023, Volume: 7 Issue: 3, 139 - 147, 30.09.2023
https://doi.org/10.30621/jbachs.1251111

Abstract

References

  • Schmid F, Goepfert MS, Kuhnt D, et al. The wolf is crying in the operating room: Patient monitor and anesthesia workstation alarming patterns during cardiac surgery. Anesthesia and Analgesia, 2011, 112(1), 78–83. https://doi.org/10.1213/ANE.0b013e3181fcc504.
  • American Anesthesiology Association. Standards for Postanesthesia Care Committee. In Αγαη, 2019, 8, (5). https://www.asahq.org/standards-and-guidelines/standards-for-postanesthesia-care.
  • Apfelbaum JL, Silverstein JH, Chung FF, et al. Practice guidelines for postanesthetic care. Anesthesiology, 2013, 118(2), 291–307. https://doi.org/10.1097/aln.0b013e31827773e9.
  • American College of Clinical Engineering Healthcare Technology Foundation. JCE_Alarms_Paper.pdf. Journal of Clinical Engineering, 2017, January-March, 22–33.
  • Lewis CL, Oster CA. Research outcomes of implementing CEASE: An innovative, nurse-driven, evidence-based, patient-customized monitoring bundle to decrease alarm fatigue in the intensive care unit/step-down unit. Dimensions of Critical Care Nursing, 2019, 38(3), 160–173. https://doi.org/10.1097/DCC.0000000000000357.
  • Kuckartz Pergher A, Carlos Lyra da Silva R. Alarms Fatigue: Integrative Review Fadiga De Alarmes: Revisão Integrativa Fatiga De Alarma: Revisión Integradora Integrative Review Article. J Nurs UFPE line. 2013;7(4):1241-124. doi:10.5205/reuol.3188-26334-1-LE.0704201322.
  • Drew B J, Harris P, Zègre-Hemsey JK, et al. Insights into the problem of alarm fatigue with physiologic monitor devices: A comprehensive observational study of consecutive intensive care unit patients. PLoS ONE, 2014, 9 (10). https://doi.org/10.1371/journal.pone.0110274.
  • Dursun Ergezen F, Kol E. Nurses’ responses to monitor alarms in an intensive care unit: An observational study. Intensive and Critical Care Nursing, 2020, 59, 102845. https://doi.org/10.1016/j.iccn.2020.102845.
  • Siebig S, Kuhls S, Imhoff M, et al. Intensive care unit alarms-How many do we need? Critical Care Medicine, 2010, 38(2), 451–456. https://doi.org/10.1097/CCM.0b013e3181cb0888.
  • Vreman J, Van Loon LM, Van den Biggelaar W, et al. Contribution of alarm noise to average sound pressure levels in the ICU: An observational cross-sectional study. Intensive and Critical Care Nursing, 2020, Van, 102901. https://doi.org/10.1016/j.iccn.2020.102901.
  • Yeh J, Wilson R, Young L, et al. Team-Based intervention to reduce the impact of nonactionable alarms in an adult intensive care unit. Journal of Nursing Care Quality, 2020, 35(2), 115–122. https://doi.org/10.1097/NCQ.0000000000000436.
  • Sendelbach S, Funk M. Alarm fatigue: A patient safety concern. AACN Advanced Critical Care, 2013, 24(4), 378–386. https://doi.org/10.1097/NCI.0b013e3182a903f9.
  • Varisco G, Mortel H, Cabrera-Quiros L, et al. Optimization of clinical workflow and monitor settings safely reduce alarms in the NICU. Acta Pediatrica. 2021; 110:1141–1150. https://doi.org/10.1111/apa.15615
  • Larson A. Clinical alarms management in the intermediate cardiology and cardiovascular intensive care units at the university of Iowa hospital and clinics by. 2018, https://ir.uiowa.edu/honors_theses/176. 15. Lawless S. Crying wolf: False alarms in a pediatric intensive care unit. Critical Care Medicine, 1994, 22(6), 981–985.
  • Suba S, Hu X, Pelter M, Sandoval C. ECG monitoring during end-of-life care: Implications on alarm fatigue (Vol. 3, Issue 1). Multimodal Technol Interact. 2019, 3, 18; doi:10.3390/mti3010018.
  • West P, Abbott P, Probst P. Alarm fatigue: A concept analysis. Online Journal of Nursing Informatics, 2014, 18(2).
  • Joint Commission on Accreditation of Healthcare Organizations. Sound the alarm: Managing physiologic monitoring systems. In Joint Commission Perspectives on Patient Safety, 2011, (Vol. 11, Issue 12). https://www.jointcommission.org/-/media/deprecated-unorganized/imported-assets/tjc/system folders/asset manager/perspectives alarm pdf. (Accessed on 11 March 2018).
  • American Association of Critical Care Nurses. AACN Practice alert. Critical Care Nurse, 2013, 33(5), 83–87.
  • Emergency Care Research Institute. 2014. The path to alarm safety (Issue March). https://www.ecri.org/Resources/In_the_News/The_Path_to_Alarm_Safety(TechNation).pdf (accessed on15 June, 2019).
  • Joint Commission on Accreditation of Healthcare Organizations. Alarm system safety, R 3 Report. Requirement, Rationale, Reference. 2013, Issue 5, December 11, https://www.jointcommission.org/standards/r3-report/r3-report-issue-5-alarm-system-safety (accessed on 15 March 2018).
  • Joint Commission on Accreditation of Healthcare Organizations. National patient safety goals effective, 2019 (Issue January) https://www.jointcommissioninternational.org/standards/international-patient-safety goals/ (accessed on 5 April 2019).
  • American Society of Peri Anesthesia Nurses. A position statement on alarm management. 2019, https://www.aspan.org/Portals/6/docs/ClinicalPractice/PositionStatement/Current/PS_12.pdf?ver=2021-01-12-150829-287.
  • Welch J, Rayo M, Kanter B, et al. Framework for alarm management process maturity. Biomedical Instrumentation and Technology, 2016, 50(3), 165–179. https://doi.org/10.2345/0899-8205-50.3.165.
  • Winters BD. Effective approaches to control non-actionable alarms and alarm fatigue. Journal of Electro Cardiology, 2018, 51(6), S49–S51. https://doi.org/10.1016/j.jelectrocard.2018.07.007.
  • Gross B, Dahl D, Nielsen L. Physiologic monitoring alarm load on medical/surgical floors of a community hospital. Biomedical Instrumentation and Technology, 2011, 45(SPRING), 29–36. https://doi.org/10.2345/0899-8205-45.s1.29
  • Graham KC, Cvach M. Monitor alarm fatigue: Standardizing use of physiological monitors and decreasing nuisance alarms. American Journal of Critical Care, 2010, 19(1), 28–34. https://doi.org/10.4037/ajcc2010651
  • Sowan AK, Gomez TM, Tarriela AF, et al. Changes in default alarm settings and standard in-service are insufficient to improve alarm fatigue in an intensive care unit: A pilot project. JMIR Human Factors, 2016, 3(1), e1. https://doi.org/10.2196/humanfactors.5098.
  • Poncette AS, Mosch L, Spies C, et al. Improvements in patient monitoring in the intensive care unit: Survey study. Journal of Medical Internet Research, 2020, 22(6). https://doi.org/10.2196/19091.
  • Dandoy CE, Davies SM, Flesch L, et al. A team-based approach to reducing cardiac. Pediatrics, 2014, 134(6), e1686–e1694. https://doi.org/10.1542/peds.2014-1162.
  • Chambrin MC, Calvelo-Aros D, Jaborska A, et al. Multicentric study at monitoring alarms in the adult intensive care unit (ICU): A descriptive analysis. Intensive Care Medicine, 1999, 25(12), 1360–1366. https://doi.org/10.1007/s001340051082.
  • Koski EMJ, Mäkivirta A, Sukuvaara T, Kari A. Clinicians’ opinions on alarm limits and urgency of therapeutic responses. International Journal of Clinical Monitoring and Computing, 1995, 12(2), 85–88. https://doi.org/10.1007/BF01142488.
  • Sahoo T, Joshi M, Madathil S, et al. Quality improvement initiative for reduction of false alarms from multiparameter monitors in neonatal intensive care unit. J Educ Health Promote, 2019; 8, 203.
  • Cvach M, Doyle P, Wong SY, et al. Decreasing pediatric PACU noise level and alarm fatigue: A quality improvement initiative to improve safety and satisfaction. Journal of Peri Anesthesia Nursing, 2020, 35(4), 357–364. https://doi.org/10.1016/j.jopan.2020.01.011.
  • Salous M, Alkhawaldeh J, Kewan S, et al. Nurses’ attitudes related to alarm fatigue in critical care units: A systematic review. IOSR Journal of Nursing and Health Science, 2017, 6(2), 62–66. https://doi.org/10.9790/1959-0602076266.
  • Emergency Care Research Institute. The alarm safety handbook. 2017, https://www.ecri.org/alarm-safety-handbook (accessed on 15 June, 2019).
  • Joint Commission on Accreditation of Healthcare Organizations. Hospital national patient safety goals. Hospital national patient safety goals, 2016, 1–17. www.jointcommission.org (accessed on 11 March 2018).
  • Bi J, Yin X, Li H, et al. Effects of monitor alarm management training on nurses’ alarm fatigue: A randomized controlled trial. Journal of Clinical Nursing, 2020, July, 1–14. https://doi.org/10.1111/jocn.15452.
  • Wilken M, Klausen A, Röhrig R, et al. Alarm fatigue: Causes and effects. Studies in Health Technology and Informatic, 2017, 243. https://doi.org/10.3233/978-1-61499-808-2-107.

Ensuring Specificity as a Strategy for Increasing Alarm Safety

Year 2023, Volume: 7 Issue: 3, 139 - 147, 30.09.2023
https://doi.org/10.30621/jbachs.1251111

Abstract

Backround: Alarms are systems created to ensure patient safety. However, when its specificity is not ensured, false positive alarms occur, causing the crying wolf phenomenon and compromising patient safety.
Purpose: This study aimed to decrease the number of false-positive alarms by ensuring the standardization and specificity of alarms.
Methods: This prospective, quasi-experimental study with a pre/post intervention study was conducted in the adult intensive care unit of a training and research hospital through repeated measurements at the beginning and after the intervention.
Results: The total alarm load decreased by 46% after the intervention, with the heart rate, saturation, and blood pressure alarms being reduced at a rate of 59%, 56%, and 23%, respectively. The hourly mean number of alarms decreased from 16.8 to 9. Differences between heart rate, oxygen saturation, and blood pressure alarms in terms of the parameter were statistically significant (p<0.05).
Conclusion: The study showed that the number of alarms can be decreased by standardizing the alarms and ensuring specificity in the adult intensive care unit.

References

  • Schmid F, Goepfert MS, Kuhnt D, et al. The wolf is crying in the operating room: Patient monitor and anesthesia workstation alarming patterns during cardiac surgery. Anesthesia and Analgesia, 2011, 112(1), 78–83. https://doi.org/10.1213/ANE.0b013e3181fcc504.
  • American Anesthesiology Association. Standards for Postanesthesia Care Committee. In Αγαη, 2019, 8, (5). https://www.asahq.org/standards-and-guidelines/standards-for-postanesthesia-care.
  • Apfelbaum JL, Silverstein JH, Chung FF, et al. Practice guidelines for postanesthetic care. Anesthesiology, 2013, 118(2), 291–307. https://doi.org/10.1097/aln.0b013e31827773e9.
  • American College of Clinical Engineering Healthcare Technology Foundation. JCE_Alarms_Paper.pdf. Journal of Clinical Engineering, 2017, January-March, 22–33.
  • Lewis CL, Oster CA. Research outcomes of implementing CEASE: An innovative, nurse-driven, evidence-based, patient-customized monitoring bundle to decrease alarm fatigue in the intensive care unit/step-down unit. Dimensions of Critical Care Nursing, 2019, 38(3), 160–173. https://doi.org/10.1097/DCC.0000000000000357.
  • Kuckartz Pergher A, Carlos Lyra da Silva R. Alarms Fatigue: Integrative Review Fadiga De Alarmes: Revisão Integrativa Fatiga De Alarma: Revisión Integradora Integrative Review Article. J Nurs UFPE line. 2013;7(4):1241-124. doi:10.5205/reuol.3188-26334-1-LE.0704201322.
  • Drew B J, Harris P, Zègre-Hemsey JK, et al. Insights into the problem of alarm fatigue with physiologic monitor devices: A comprehensive observational study of consecutive intensive care unit patients. PLoS ONE, 2014, 9 (10). https://doi.org/10.1371/journal.pone.0110274.
  • Dursun Ergezen F, Kol E. Nurses’ responses to monitor alarms in an intensive care unit: An observational study. Intensive and Critical Care Nursing, 2020, 59, 102845. https://doi.org/10.1016/j.iccn.2020.102845.
  • Siebig S, Kuhls S, Imhoff M, et al. Intensive care unit alarms-How many do we need? Critical Care Medicine, 2010, 38(2), 451–456. https://doi.org/10.1097/CCM.0b013e3181cb0888.
  • Vreman J, Van Loon LM, Van den Biggelaar W, et al. Contribution of alarm noise to average sound pressure levels in the ICU: An observational cross-sectional study. Intensive and Critical Care Nursing, 2020, Van, 102901. https://doi.org/10.1016/j.iccn.2020.102901.
  • Yeh J, Wilson R, Young L, et al. Team-Based intervention to reduce the impact of nonactionable alarms in an adult intensive care unit. Journal of Nursing Care Quality, 2020, 35(2), 115–122. https://doi.org/10.1097/NCQ.0000000000000436.
  • Sendelbach S, Funk M. Alarm fatigue: A patient safety concern. AACN Advanced Critical Care, 2013, 24(4), 378–386. https://doi.org/10.1097/NCI.0b013e3182a903f9.
  • Varisco G, Mortel H, Cabrera-Quiros L, et al. Optimization of clinical workflow and monitor settings safely reduce alarms in the NICU. Acta Pediatrica. 2021; 110:1141–1150. https://doi.org/10.1111/apa.15615
  • Larson A. Clinical alarms management in the intermediate cardiology and cardiovascular intensive care units at the university of Iowa hospital and clinics by. 2018, https://ir.uiowa.edu/honors_theses/176. 15. Lawless S. Crying wolf: False alarms in a pediatric intensive care unit. Critical Care Medicine, 1994, 22(6), 981–985.
  • Suba S, Hu X, Pelter M, Sandoval C. ECG monitoring during end-of-life care: Implications on alarm fatigue (Vol. 3, Issue 1). Multimodal Technol Interact. 2019, 3, 18; doi:10.3390/mti3010018.
  • West P, Abbott P, Probst P. Alarm fatigue: A concept analysis. Online Journal of Nursing Informatics, 2014, 18(2).
  • Joint Commission on Accreditation of Healthcare Organizations. Sound the alarm: Managing physiologic monitoring systems. In Joint Commission Perspectives on Patient Safety, 2011, (Vol. 11, Issue 12). https://www.jointcommission.org/-/media/deprecated-unorganized/imported-assets/tjc/system folders/asset manager/perspectives alarm pdf. (Accessed on 11 March 2018).
  • American Association of Critical Care Nurses. AACN Practice alert. Critical Care Nurse, 2013, 33(5), 83–87.
  • Emergency Care Research Institute. 2014. The path to alarm safety (Issue March). https://www.ecri.org/Resources/In_the_News/The_Path_to_Alarm_Safety(TechNation).pdf (accessed on15 June, 2019).
  • Joint Commission on Accreditation of Healthcare Organizations. Alarm system safety, R 3 Report. Requirement, Rationale, Reference. 2013, Issue 5, December 11, https://www.jointcommission.org/standards/r3-report/r3-report-issue-5-alarm-system-safety (accessed on 15 March 2018).
  • Joint Commission on Accreditation of Healthcare Organizations. National patient safety goals effective, 2019 (Issue January) https://www.jointcommissioninternational.org/standards/international-patient-safety goals/ (accessed on 5 April 2019).
  • American Society of Peri Anesthesia Nurses. A position statement on alarm management. 2019, https://www.aspan.org/Portals/6/docs/ClinicalPractice/PositionStatement/Current/PS_12.pdf?ver=2021-01-12-150829-287.
  • Welch J, Rayo M, Kanter B, et al. Framework for alarm management process maturity. Biomedical Instrumentation and Technology, 2016, 50(3), 165–179. https://doi.org/10.2345/0899-8205-50.3.165.
  • Winters BD. Effective approaches to control non-actionable alarms and alarm fatigue. Journal of Electro Cardiology, 2018, 51(6), S49–S51. https://doi.org/10.1016/j.jelectrocard.2018.07.007.
  • Gross B, Dahl D, Nielsen L. Physiologic monitoring alarm load on medical/surgical floors of a community hospital. Biomedical Instrumentation and Technology, 2011, 45(SPRING), 29–36. https://doi.org/10.2345/0899-8205-45.s1.29
  • Graham KC, Cvach M. Monitor alarm fatigue: Standardizing use of physiological monitors and decreasing nuisance alarms. American Journal of Critical Care, 2010, 19(1), 28–34. https://doi.org/10.4037/ajcc2010651
  • Sowan AK, Gomez TM, Tarriela AF, et al. Changes in default alarm settings and standard in-service are insufficient to improve alarm fatigue in an intensive care unit: A pilot project. JMIR Human Factors, 2016, 3(1), e1. https://doi.org/10.2196/humanfactors.5098.
  • Poncette AS, Mosch L, Spies C, et al. Improvements in patient monitoring in the intensive care unit: Survey study. Journal of Medical Internet Research, 2020, 22(6). https://doi.org/10.2196/19091.
  • Dandoy CE, Davies SM, Flesch L, et al. A team-based approach to reducing cardiac. Pediatrics, 2014, 134(6), e1686–e1694. https://doi.org/10.1542/peds.2014-1162.
  • Chambrin MC, Calvelo-Aros D, Jaborska A, et al. Multicentric study at monitoring alarms in the adult intensive care unit (ICU): A descriptive analysis. Intensive Care Medicine, 1999, 25(12), 1360–1366. https://doi.org/10.1007/s001340051082.
  • Koski EMJ, Mäkivirta A, Sukuvaara T, Kari A. Clinicians’ opinions on alarm limits and urgency of therapeutic responses. International Journal of Clinical Monitoring and Computing, 1995, 12(2), 85–88. https://doi.org/10.1007/BF01142488.
  • Sahoo T, Joshi M, Madathil S, et al. Quality improvement initiative for reduction of false alarms from multiparameter monitors in neonatal intensive care unit. J Educ Health Promote, 2019; 8, 203.
  • Cvach M, Doyle P, Wong SY, et al. Decreasing pediatric PACU noise level and alarm fatigue: A quality improvement initiative to improve safety and satisfaction. Journal of Peri Anesthesia Nursing, 2020, 35(4), 357–364. https://doi.org/10.1016/j.jopan.2020.01.011.
  • Salous M, Alkhawaldeh J, Kewan S, et al. Nurses’ attitudes related to alarm fatigue in critical care units: A systematic review. IOSR Journal of Nursing and Health Science, 2017, 6(2), 62–66. https://doi.org/10.9790/1959-0602076266.
  • Emergency Care Research Institute. The alarm safety handbook. 2017, https://www.ecri.org/alarm-safety-handbook (accessed on 15 June, 2019).
  • Joint Commission on Accreditation of Healthcare Organizations. Hospital national patient safety goals. Hospital national patient safety goals, 2016, 1–17. www.jointcommission.org (accessed on 11 March 2018).
  • Bi J, Yin X, Li H, et al. Effects of monitor alarm management training on nurses’ alarm fatigue: A randomized controlled trial. Journal of Clinical Nursing, 2020, July, 1–14. https://doi.org/10.1111/jocn.15452.
  • Wilken M, Klausen A, Röhrig R, et al. Alarm fatigue: Causes and effects. Studies in Health Technology and Informatic, 2017, 243. https://doi.org/10.3233/978-1-61499-808-2-107.
There are 38 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Gülnur Gül 0000-0001-7115-6254

Şeyda Seren İntepeler 0000-0001-8615-9765

Publication Date September 30, 2023
Submission Date February 14, 2023
Published in Issue Year 2023 Volume: 7 Issue: 3

Cite

APA Gül, G., & Seren İntepeler, Ş. (2023). Ensuring Specificity as a Strategy for Increasing Alarm Safety. Journal of Basic and Clinical Health Sciences, 7(3), 139-147. https://doi.org/10.30621/jbachs.1251111
AMA Gül G, Seren İntepeler Ş. Ensuring Specificity as a Strategy for Increasing Alarm Safety. JBACHS. September 2023;7(3):139-147. doi:10.30621/jbachs.1251111
Chicago Gül, Gülnur, and Şeyda Seren İntepeler. “Ensuring Specificity As a Strategy for Increasing Alarm Safety”. Journal of Basic and Clinical Health Sciences 7, no. 3 (September 2023): 139-47. https://doi.org/10.30621/jbachs.1251111.
EndNote Gül G, Seren İntepeler Ş (September 1, 2023) Ensuring Specificity as a Strategy for Increasing Alarm Safety. Journal of Basic and Clinical Health Sciences 7 3 139–147.
IEEE G. Gül and Ş. Seren İntepeler, “Ensuring Specificity as a Strategy for Increasing Alarm Safety”, JBACHS, vol. 7, no. 3, pp. 139–147, 2023, doi: 10.30621/jbachs.1251111.
ISNAD Gül, Gülnur - Seren İntepeler, Şeyda. “Ensuring Specificity As a Strategy for Increasing Alarm Safety”. Journal of Basic and Clinical Health Sciences 7/3 (September 2023), 139-147. https://doi.org/10.30621/jbachs.1251111.
JAMA Gül G, Seren İntepeler Ş. Ensuring Specificity as a Strategy for Increasing Alarm Safety. JBACHS. 2023;7:139–147.
MLA Gül, Gülnur and Şeyda Seren İntepeler. “Ensuring Specificity As a Strategy for Increasing Alarm Safety”. Journal of Basic and Clinical Health Sciences, vol. 7, no. 3, 2023, pp. 139-47, doi:10.30621/jbachs.1251111.
Vancouver Gül G, Seren İntepeler Ş. Ensuring Specificity as a Strategy for Increasing Alarm Safety. JBACHS. 2023;7(3):139-47.