The Joint Commission (TJC) has made better alarm management a national patient safety goal. In Sentinel Event Alert #50 “Medical device alarm safety in hospitals”, TJC has stated:
The number of alarm signals per patient per day can reach several hundred depending on the unit within the hospital, translating to thousands of alarm signals on every unit and tens of thousands of alarm signals throughout the hospital every day. It is estimated that between 85 and 99 percent of alarm signals do not require clinical intervention, such as when alarm conditions are set too tight; default settings are not adjusted for the individual patient or for the patient population; ECG electrodes have dried out; or sensors are mispositioned. As a result, clinicians become desensitized or immune to the sounds, and are overwhelmed by information – in short, they suffer from “alarm fatigue.” In response to this constant barrage of noise, clinicians may turn down the volume of the alarm, turn it off, or adjust the alarm settings outside the limits that are safe and appropriate for the patient – all of which can have serious, often fatal, consequences.
In a recent Alarm Management Practice Alert, the American Association of Critical-Care Nurses (AACN) has provided expected practice and nursing actions regarding how to reduce ECG alarms.
Here are AACN’s 7 expected practice and nursing actions:
- Provide proper skin preparation for ECG electrodes.
- Change ECG electrodes daily.
- Customize alarm parameters and levels on ECG monitors.
- Customize delay and threshold settings on oxygen saturation via pulse oximetry (SpO2) monitors.
- Provide initial and ongoing education about devices with alarms.
- Establish interprofessional teams to address issues related to alarms, such as the development of policies and procedures.
- Monitor only those patients with clinical indications for monitoring.
To read the AACN alert, please click here.
What do you think of these recommendations? Do you think that these can be applied to other medical devices?