Alarm fatigue

Heard this article on NPR this morning on alarms used in hospitals.

Highlights from the article:

Alarms are good and necessary things in hospital care, except when there are so many of them that caregivers can’t keep track of the ones that signal a crisis that requires immediate attention. Then it may be that less technology can actually be more effective.

In the case of Boston Medical Center, an analysis found that 7 North was experiencing 12,000 alarms ­a day, on average. That kind of cacophony was producing a growing problem known as “alarm fatigue.”

“Alarm fatigue is when there are so many noises on the unit that it actually desensitizes the staff,” says Deborah Whalen, a clinical nurse manager at the Boston hospital. “If you have multiple, multiple alarms going off with varying frequencies, you just don’t hear them.”

That can be dangerous. Patients can die when an important alarm is missed, or an electrode on a patient’s chest comes unstuck, or a monitor’s battery goes dead.

Boston Medical Center is attracting national attention as a hospital that apparently has conquered alarm fatigue. Its analysis showed the vast majority of so-called “warning” alarms, indicating potential problems with such things as low heart rate, don’t need an audible signal. The hospital decided it was safe to switch them off.

The hospital also upgraded some low-level “warning” alarms to a higher level, signifying “crisis” — for instance, a pause in heart rhythm. And nurses were given authority to change alarm settings to account for patients’ differences.

“Once that happened,” nurse Deborah Whalen says, “many, many, many alarms disappeared. And instead of 90,000 alarms a week, we dropped to 10,000 alarms a week.” That’s on 7 North alone.

The article also mentioned that alarm fatigue is one of the top priorities for the Joint Commision

RD: This article reminds me of a lot of the meetings I sit in. We want to track everything, just in case someone asks us a question. It doesn’t matter if what we are measuring is really important or not to the health of the organization. Some leaders think that what they need is more information to make a decision. I think some use it as an excuse to keep from making a decision. Because of this constant need to measure everything, we get bogged down in the noise, and fail to hear the true alarms. The alarms that are going off to signal the impending doom of an organization.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s