Clinical Alarm Fatigue Can Be Safely Eased With Widened Parameters

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Up to 80% of alarms may be not actionable, leading to alarm fatigue.
Up to 80% of alarms may be not actionable, leading to alarm fatigue.
The following article features coverage from the National Association of Clinical Nurse Specialists (NACNS) 2018 Annual Conference in Austin, Texas. Click here to read more of Oncology Nurse Advisor's conference coverage. 

Cardiac alarm monitoring optimization using evidence-based widened parameters can ease alarm fatigue for nurse staff and provide a safer, quieter environment for patients, according to a presentation at the National Association of Certified Nurse Specialists (NACNS) 2018 Annual Meeting.

Alarm fatigue is a major concern for hospitals that has led to recommendations from the Joint Commission, the Agency for Healthcare Research and Quality (AHRQ), ECRI Institute, and the MAUDE database. Nurses spend 16% to 35% of their time responding to clinical alarms, and 50% to 80% of alarms are not actionable leading to alarm fatigue. The negative effects include diminished patient confidence and trust in the healthcare team and staff desensitization to alarms.

For this project, a cardiac monitoring alarm optimization project was designed and implemented to help alleviate alarm fatigue. Working with the hospital's data analyst, CNSs designed an interactive Excel document that showed the effects of various default changes on the alarm burden for each unit.


Each unit's interdisciplinary leadership team and nurse alarm champions were educated on alarm fatigue and potential interventions such as evidence-based recommendations for widening default parameters. Using the Excel document, each unit was able to weigh the risks and benefits of widened parameters using their actual data.

In the pilot unit, the total number of alarms was reduced by 39%. Coupled with staff education to individualize alarms and monitor changes to volume and profiles, alarm fatigue has improved among the staff. This ongoing project is continuing throughout the hospital to address clinical alarm management in all areas with cardiac monitoring.


With this project, the CNS team systematically reduced the number of nonactionable and nuisance alarms in each area, providing a substantially quieter and safer environment for patients and nurses.

Reference

Carpenter M, Solano L. Clinical alarm management — stop the nuissance. Oral presentation at: NACNS 2018 Annual Conference; February 28-March 3, 2018; Austin, TX.

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