Targeting Pulse Oximetry Alarms Phase III
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1 Targeting Pulse Oximetry Alarms Phase III Clinical Alarm TASK FORCE Prperty f BMC. Nt reprducible withut permissin. April 28, 2015
2 Apprpriate Use Order Sets, $ Reduce Alarms BMC Patient Safety Grant Late Spring Spring 15 Cnvene Arrhythmia HR Changes Phase II Tachy Prject Prperty f BMC. Nt reprducible withut permissin. April 28, 2015
3 Open t Services Fcus Grups Expand size f team Ensure crss representatin Understand patient ppulatins Clinical Observatin Interview and bserve staff Capture anecdtal data t help frame educatin Pilt Unit(s) Identified tw busy IMCU s Vlunteered! Leverage Hx The prcess is imprtant it is accepted Best Practices Review Data Assessment What alarms ccur and why Help drive default changes Plicy + Order Set Review Create a dcument t help determine prper utilizatin Supplement this with tips and educatinal supprt materials Wrap plicy feedback and discussins int rder set Create Educatin and Rllut Plan Prperty f BMC. Nt reprducible withut permissin. April 28, 2015
4 Clinical Alarm TASK FORCE Create a brader representatin f members given diverse needs Original Band Members Nursing Clinical Instructrs Nursing Leadership Cardilgy Clinical Engineering IT Plus.. Pulmnary Medicine Respiratry Care CT Surgery Bariatric Surgery Trauma ENT Medical Residency Surgical Residency Prperty f BMC. Nt reprducible withut permissin. April 28, 2015
5 Pulse Oximetery Alarms - Data extracted frm CIC Data captured 2 weeks pre pilt and 2 weeks pst pilt t evaluate changes Campus Area L Rate L Rate Hi Prbe Sensr Cnnect Prbe Pulse Search Ttal Week Warning Warning Warning Warning Warning Slar Message M5WIMCU 1 58, , ,803 78,449 M5WIMCU 2 52, , ,860 M5WIMCU 3 48, , ,427 M5WIMCU 4 45, , ,645 M6East 1 4,020 4, , ,326 M6East 2 12,531 12, , ,538 M6East ,370 M6East 4 6,710 6, ,926 M6West 1 1, ,411 M6West 2 5, ,323 M6West 3 2, , ,709 M6West 4 10, , ,002 15,060 While cllecting data n Tachycardia Alarms, we als captured sme baseline SpO2 data L Rate L Rate Hi Prbe Sensr Pulse Search Ttal Warning Warning Warning Warning Warning Message Menin Units 283,776 25, , , ,630 Newtn Units 148, ,163 26,705 1,623 2, ,805 M7East 1 9, , ,954 13,414 M7East 2 8, , ,657 12,114 M7East 3 7, , ,297 10,164 M7East 4 10, , ,403 14,934 Menin Units 283,776 25, , , ,670 EN6West 1 9, , ,852 EN6West 2 1, ,532 EN6West EN6West 4 3, ,698 EN7Nrth ,418 EN7Nrth EN7Nrth 3 1, ,817 EN7Nrth EN7East EN7East 2 3, ,974 EN7East 3 3,391 1, ,840 EN7East 4 1, ,682 EN7West 1 1 EN7West EN7West 3 3, ,456 EN7West 4 2, ,026 EN8West 1 10, , ,903 EN8West 2 3, ,310 EN8West EN8West 4 1, ,706 EN8EIMCU 1 30, , ,915 EN8EIMCU 2 25, , ,252 EN8EIMCU 3 20,832 2, ,822 EN8EIMCU 4 23,413 7, ,696 Newtn Units 148, ,163 26,705 1, , ,865 Pre-Pilt Data March 2015 Cnsistent Lw SpO2 Prbe Off Pulse Search Prperty f BMC. Nt reprducible withut permissin. April 28, 2015
6 Clinical Observatin + Staff Assessment Cmmittee Rle Observe use and alarms Capture Alarms O2 use r nt Speak with prviders Specific questins Identify cntinuus vs VS Orders r Nt Additinal cmments Allw staff t add thughts Observer bservatins Prperty f BMC. Nt reprducible withut permissin. April 28, 2015
7 Plicy Review + Enhancements Cllabrate with key stakehlders n plicy language Respiratry Nursing Pulmnary Etc. Create Clinical Indicatins Clinical Guidelines Clinical Reference Prcedures Interventins [Trubleshting] Addendum Prperty f BMC. Nt reprducible withut permissin. April 28, 2015
8 Pilt Units + Rll Out Plan Tw IMCU s have vlunteered t pilt the changes we are recmmending 26 Bed + 20 Bed units Heavily mnitred as well as telemetry capable High use f Oximetry High vlume f alarms Initial Changes Change Lw O2Sat parameter limit [tbd] and make it a Crisis [Actinable] Change High O2Sat limit [tbd] Change O2 Sat Rate [tbd] Optimize delay and Sensitivity [tbd] Create Order sets that reflect apprpriate use Cntinuus versus Episdic rules fr cntinuus Evaluate cmmunicatin requirements t staff fr rder changes Create Educatinal package fr Super Users t help supprt staff Mimic ther pilt prjects: 2 RN r RN and RT t make changes prir t rder change Evaluate new cmpetency exam fr staff [tbd] Pilt n each unit fr tw weeks t evaluate changes and mdify as needed Prperty f BMC. Nt reprducible withut permissin. April 28, 2015
9 Prperty f BMC. Nt reprducible withut permissin. April 28, 2015
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