Kelly Conklin, MSN, CENP, VP and Chief Clinical Officer, PerfectServe
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Healthcare, We Have a Problem:
Alarm fatigue is a serious threat to patient safety.
The American Association of Critical-Care Nurses (AACN) defines alarm fatigue as a sensory overload that occurs when clinicians are exposed to an excessive number of alarms, which can result in desensitization to alarm sounds and an increased rate of missed alarms. False alarms are a strong contributor, making up 72-99% of all alarms and numbing care teams to signals meant to indicate patient danger.1
Essentially, devices and processes that were designed to protect and support patients in specific ways have compiled over time to create a cacophony of ever-sounding silos in healthcare. Sadly, the discord cannot be safely silenced. Fortunately, it can be well-orchestrated.
Let’s explore how integrating disparate, noisy alert and alarm systems can help fight alarm fatigue for nurses and care teams.
Where is all the noise coming from?
In short, disconnected legacy systems with outdated hardware and devices combine with overlapping, suboptimal workflows to create the noise fueling alarm fatigue. A few factors that add to the chaos and make it difficult for clinicians to determine the relevance and urgency of alarms include:
- Nurse Call Systems: Patients sometimes use nurse call for non-clinical requests, such as a glass of water, which could be redirected to another team member.
- Critical Lab Results: Upon notification, nurses in some settings are responsible for tracking down the appropriate physician to relay critical results, pulling the nurse away from the bedside.
- Patient Monitoring Devices: It can be difficult to infer the risk level and urgency of various patient device alarms, and to know if other team members are responding or can respond more quickly.
Above are just a few of many systems that can trigger nondescript beeping sounds, which all begin to sound alike and blur together. The result? Just to find out where an alarm is coming from and what it indicates, a nurse has to leave the current task to investigate.
The nurse is forced to assign priority (current task versus potential patient threat) based on assumption in an environment where up to 99% of alarms are false, yet assuming an alarm is false puts a patient at risk. Constant decisions like these in a fast-paced, high-stakes environment contribute to mistakes, alarm fatigue, clinician burnout, patient risk, and many other potential consequences.
5 Steps to Fight Alarm Fatigue:
1. Integrate all alerts and alarms to reduce noise.
To start, put all alerts and alarms in one place that nurses and care teams can check on the go—an integrated app accessible from any device across all locations.
2. Increase mobility to decrease footwork.
For organizations that haven’t already deployed a mobile device strategy for nurses, smartphones will greatly enhance the effectiveness of an integrated solution. Being able to check alerts at the bedside and on the move reduces extra footwork and detours for staff.
3. Use shift schedules to inform smart routing.
The ideal solution should also integrate with shift and on-call schedules across the organization, using schedules to route alerts and alarms directly to the right clinicians. Smart routing like PerfectServe’s Dynamic Intelligent Routing reduces irrelevant noise while using built-in escalation policies to ensure urgent alerts are addressed within set timeframes.
4. Delay nonurgent notifications to reduce interruptions.
The ability to delay nonurgent alerts to be delivered at set intervals can greatly reduce distractions for clinicians during patient care. By minimizing multitasking, nurses and other care team members are able to complete tasks more efficiently and maximize their focus on patients at the bedside.
5. Distinguish alert types by tone to simplify recognition.
Alarm fatigue and decision fatigue often go hand in hand. While most care team members wouldn’t actively choose to ignore an alert, the ability to know in an instant based on sound whether or not an alarm is urgent can help them respond appropriately more quickly.
The Bottom Line:
Excess noise makes it difficult for clinicians to administer safe and timely care. (It also does a number on patient experience, but that’s a topic for another post.) Remove the guesswork for nurses around whether to tune out the noise and focus on the patient at hand or interrupt each encounter to assess the latest (likely false) alarm.
Click below to begin fighting alarm fatigue.
1. Alarm Fatigue: A Patient Safety Concern, American Association of Critical-Care Nurses (AACN) Advanced Critical Care, Sue Sendelbach, RN, PhD, CCNS and Marjorie Funk, RN, PhD, Oct. 2013: acnjournals.org/aacnacconline/article-abstract/24/4/378/14745/Alarm-FatigueA-Patient-Safety-Concern