Managing medical device alarms in the hospital setting

IN FOCUS

Managing medical device alarms in the hospital setting

PERIOP BRIEFING

Marcie C. Jannetti, BSN, RN, CNOR

Alarm hazards, specically inadequate alarm conguration policies and practices, are considered to be the top health technology

hazard category for 2015.1 Statistics from The Joint Commissions Sentinel Event database show that80 of 98 alarm-related events reported between January 2009 and June 2012 resulted in the death of a patient.2 In response to increasing patient safety risks linked to alarm hazards in recent years, The Joint Commission issued a Sentinel Event Alert in 2013 on medical device alarm safety in hospitals and established a National Patient Safety Goal for clinical alarm safety effective January 2014.2,3

The Sentinel Event Alert recognizes that, depending on the hospital unit, there may be hundreds of alarm signals per patient per day from medical devices, such as electrocardiogram machines, ventilators, and infusion pumps.2

However, The Joint Commission suggests more than 85 percent of such alarms require no clinical intervention, meaning that the alarm is sounding for reasons such as improperly positioned sensors or dried out electrocardiogram electrodes.2 This can lead to alarm fatigue, which occurs when nurses or other care providers fail to respond to alarms in a timely manner because they have become desensitized to various alarms becauseof the frequency or number of alarms that may sound in one shift.3 Following appropriatealarm conguration practiceswhich includes determining which alarms to enable, selectingthe appropriate alarm limits, and establishing the default alarm priority levelscan help alleviate alarm fatigue and improve the overall management of clinical alarm systems.1

Assessing current alarm practices

A thorough understanding of current alarm practices in a facility may reveal vulnerabilities that need to be addressed. A multidisciplinary team that includes facility administrators, nurse managers, staff nurses, clinical engineers, IT staff, medical

staff, and risk management personnel should be involved in assessing current alarm practices. The...