Alarm Fatigue In The Emergency Room Setting
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1 Lehigh Valley Health Network LVHN Scholarly Works Patient Care Services / Nursing Alarm Fatigue In The Emergency Room Setting Justin Dickinson Lehigh Valley Health Network, justin.dickinson@lvhn.org Jocelle Flores Lehigh Valley Health Network Nora B. Walsh BSN, RN Lehigh Valley Health Network, nora_b.walsh@lvhn.org Tiffany Wilkins BSN, RN Lehigh Valley Health Network, tiffany_l.wilkins@lvhn.org Follow this and additional works at: Part of the Nursing Commons Published In/Presented At Dickinson, J., Flores, J., Walsh, N., & Wilkins, T. (2015, October 28). Alarm Fatigue In The Emergency Room Setting. Poster presented at LVHN UHC/AACN Nurse Residency Program Graduation, Lehigh Valley Health Network, Allentown, PA. This Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by an authorized administrator. For more information, please contact LibraryServices@lvhn.org.
2 Alarm Fatigue In The Emergency Room setting Nora Walsh, Tiffany Wilkins, Jocelle Flores & Justin Dickinson
3 Purpose Insignificant hospital alarms lead to: Decrease in patient satisfaction Increase in patient anxiety Decreasing caregiver s time for patient care Caregiver desensitization to alarms therefore delayed response in critical alarms
4 PICO QUESTION Are emergency room nurses who customize patient alarms compared to those who use the default settings more attentive to critical alarms? P: Emergency room nurses I: Customizing patient alarms C: In comparison to nurses using default settings O: Increased attention to critical alarms
5 EVIDENCE 80%-90% of ECG monitor alarms are deemed insignificant (Jepsen & Sendelbach, 2013) Alarms dropped from 90,000 to 10,000 over 6 weeks and a small increase in pt satisfaction scores. Implemented on other floors for overall 60% drop in alarms for the floor
6 EVIDENCE 43% reductions critical alarms observed in critical care setting (Jepsen & Sendelbach, 2013) Failure to respond to critical alarms due to desensitization is resulting in failing to catch real alarms (Korniewicz, Clark & David, 2008)
7 Barriers & Strategies Barrier: Staff uneducated on how to adjust alarms Staff being overwhelmed by patient census to considering changing alarms for each patient Strategy to Overcome: EDUCATION
8 Expected Outcomes Establish a baseline set of vital signs Using clinical judgment, adjust the alarms settings to a more personalized setting based on baseline vital signs Adjusting alarms for each patient will decrease caregivers alarm burden without compromising patient safety
9 Project Plans Two nurse residents will gather information during the same shift. One nurse resident will adjust alarms and record the number of alarms answered The other nurse resident will leave alarms at the default setting and record number of alarms answered Comparisons will be made based on the results seen
10 Current Practice at LVHN Blood Pressure Systolic: low-90 high-160 Diastolic Heart rate: Respirations: 8-30 Oxygen saturation: >90%
11 Implications at LVHN On multiple dates Jocelle and Nora both went a 12 hour shift from 3pm-3:30am. Jocelle followed our suggested practice in receiving a baseline set of vital signs and adjusting each patient s monitor settings according to that. Nora did not adjust any alarm and kept the default settings. Alarms answered on 6/7/15: Jocelle-20 alarms Nora-53 alarms
12 Date Jocelle Nora % of Less Alarms Answered 6/7/ % 7/10/ % 7/14/ % 7/24/ % 8/2/ % 8/3/ % Comparison number of alarms. Jocelle adjusted her alarms each shift and Nora did not.
13 References Creighton Graham, K., & Cvach, M. (2010). Monitor Alarm Fatigue: Standardizing Use of Physiological Monitors and Decreasing Nuisance Alarms. American Journal of Critical Care, 19(1). Cvack, M. (2012). Monitor alarm fatigue an integrative review. AAMI. ECRI institute honors the johns hopkins hospital for innovations in alarm management. (2013). ECRI Institue, Korniewicz, D., Clark, T., & David, Y. (2008). A National Online Survey On the Effectiveness of Clinical Alarms. American Journal of Critical Care, 17(1). McKinney, M. (2014). Hospital's Simple Interventions Help Reduce Alarm Fatigue. Modern Healthcare. Mitka, M. (2013). Joint Commision Warns of Alarm Fatigue: Multitude of Alarms from Monitoring Devices Problematic. JAMA, 309(22), doi: Sendelbach, S., & Jepsen, S. (2013). Alarm Management. AACN. Sound the Alarm: Managing Physiologic Monitoring Systems. (2011). The Joint Commission Perspectives on Patient Safety, 11(12). The Joint Commission Sentinel Event Alert. (2013). (50). Troubling stat from study on hospital alarm fatigue. (2015). The American Nurse.
14 Make It Happen Questions/Comments: Contact Information:
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