For many medical professionals, the workplace is a cacophony of beeping medical devices. Alarms beep when a heart rate drops, when the blood oxygen level becomes dangerously low, or when there is a sudden change in brain activity.
But alarms also beep every time a patient moves in bed and disrupts heart and blood oxygen monitors or creates a temporary kink in IV lines. They beep when a patient falls asleep and has a lower heart rate. In a single day, a hospital can have over 15,000 alarms go off.
This overwhelming number of alarms during the day creates “alarm fatigue”. Nurses and medical professionals overwhelmed by the constant beeping become desensitized and may respond by turning the volume of alarms, shutting them off completely, or turning them out.
In many cases, this will not harm the patient. Multiple studies have confirmed that 99% of alarms do not affect the safety of the patient. But that makes the 1% of vital alarms difficult to detect amid the noise, and those are the alarms indicate serious trouble for patients.
A study by the Joint Commission found over 138 reported deaths between 2010 and 2015 that were connected with alarm errors including instances of alarm fatigue where nurses turned alarm volumes down or shut the alarms off completely. Like the boy who cried wolf, too many alarms make real emergencies less detectable and create life-threatening situations.
The new year has brought a renewed focus to this problem; many hospitals are implementing simple but innovative procedures to reduce the dangers of alarm fatigue.
There are many techniques that hospitals are implementing to ameliorate this problem. Some hospitals have started using software that links with monitoring medical devices and provides a score between 1 and 100 that indicates the level of seriousness of the information. Another technique that was successfully tested by the University of California San Francisco was a 20-second delay in blood oxygen level monitors that clip on to fingers. Alarms only sound if the problem persists after 20 seconds. Other hospitals have altered alarm levels so “crisis” alarms rank above “warning” alarms that may simply signal a body movement by a patient.
Studies have found the amount of time it takes nurses to respond to alarms rises with each additional alarm. By decreasing the din of alarm noises, hospitals can help medical professionals to hear only those alarms that really matter. The technology boom that hit hospitals in the 1980s has come full circle—hospitals now need to learn how to prune technology and receive only the important information.
Patients who are aware of the problems of alarm fatigue can hep protect themselves. Ask your hospital staff about the policies they implement to avoid alarm fatigue. Patients and family members should note any long delays in alarm response times—no matter what the alarm is for—and talk to their medical professionals about concerns. If important alarms go off without response, or if the volume levels are turned too low to hear, talk to hospital staff about steps to increase effective monitoring.
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