Two studies address alarm fatigue in ICU

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 - alarm management, nuisance alarm, patient safety

Alarm fatigue within the intensive care unit (ICU) can negatively impact patient safety and lead to life-threatening events. Researchers from Harlem Hospital and Maimonides Medical Center aimed to identify solutions fight such fatigue.

The first study from New York's Harlem Hospital, published in Chest, set out to examine alarm frequency with a goal of decreasing response time to less than 60 seconds. Researchers audited all clinical alarm-sounding devices. In the 20-bed ICU, researchers were able to decrease alarm rates by 70 percent at four months after intervention.

“After an intensive educational process involving all clinicians and increasing the threshold at which alarms went off, the frequency of alarms and response time decreased significantly with the greatest reduction seen in the bedside monitor,” concluded first author Afua Kunadu and colleagues. "The reduction in alarm rate and improved response could be attributed to educational efforts, staff recognition that the alarms are now more actionable, or may be due to a reduction in alarm fatigue. These interventions, by themselves, were insufficient to decrease response time for all alarms to less than 60 seconds”

The second study, conducted at Brooklyn's Maimonides Medical Center and also published in Chest, analyzed accuracy of cardiac monitor alarms in the ICU. Over the course of a year, researchers collected data on 2,408 alarms occurring among 350 patients. Results found a large number were false alarms without any clinical significance.

“Alarm fatigue ranked first on the list of 'Top 10 Health Technology Hazards' released by Emergency Care Research Institute in 2012, 2013 and 2015. With this study, we highlight a pressing need of implementing an intelligent cardiac monitoring system in the ICUs. Besides being highly sensitive, the alarm system should also take into account other parameters before beeping,” concluded first author Parita Soni and colleagues. “Reducing the number of [false] alarms would lead to increased efficiency of the nursing staff and other medical personnel; hence would improve the patient safety.”