Fighting Alarm Fatigue for Nurses in 5 Steps

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In short, disconnected legacy systems with outdated hardware and devices combine with overlapping, suboptimal workflows to create the noise fueling alarm fatigue.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.

 

Resources:
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

Real-Time Data Entry for Better Patient Care

Real-Time Data Entry Header

It has always been recommended that charting take place as near to the care event as practical, with the key word being “practical.” In reality, clinicians and nurses often stay after shifts to do their charting because entry is not seamless during patient care.

The more time that passes between the health event and the data entry, the less detailed the data input becomes and the greater its risk of containing errors. Delayed data entry impacts patient outcomes and creates unnecessary administrative overhead.

Benefits of Real-Time Data Entry

“Real-time electronic data is a potential treasure trove of insights, which can be analysed to improve patient care and use nurses’ time more effectively.”
– Helen Glenister, Chief Operating Officer (COO) of The Learning Clinic1

Real-time data entry has been shown to improve patient care (particularly the identification of patients who may be deteriorating), free up more direct-care time for nurses and clinicians, and help hospitals better deploy staff and resources.

According to a study published in Nursing Times, the availability of up-to-date data can help nurses and clinicians spot patterns in data that indicate a patient is deteriorating or may have an infection.1 While some data points may automatically feed into the EHR, vital observational data from nurses and doctors are not automatically entered.

Timely electronic recording of all clinical data—including observations, assessments, and actions—gives the overall picture of a patient and provides a clear data trail in the event of a complaint or incident investigation. Real-time documentation and order entry during rounding also helps speed up care and minimize future interruptions.2

The benefits of real-time data entry are well known, but challenging to achieve in some hospitals.

Challenges to Real-Time Data Entry

Siloed technology systems, device mobility limitations, and logistical issues in some EHRs can be the biggest barriers to real-time charting.

“One nurse believes that since going live, EHRs have added 3 hours to a
12-hour shift.” – Laura A. Stokowski, RN, MS3

In order to chart data that is accurate, actionable, and timely, the care team must be supported with an integrated solution that allows for simplified real-time charting in the EHR/EMR.

How to Achieve Real-Time EHR Data Entry

Healthcare IT integration can be very complex, but the right technology can integrate disparate IT, clinical, telecom, and EMR/EHR systems to allow information to flow freely. The result is a cohesive, integrated communication ecosystem that ensures the right information is available at the right time to support quality patient-centered care.

An ideal solution will support real-time charting with:

  • Intelligent field mapping to reduce duplicate data entry.
  • Voice-to-text capability to speed up and simplify data entry.
  • An easy and elegant interface with all information available on a single platform; no switching between apps.
  • Easy transfer of clinical notes for rapid documentation.
  • Immediate delivery of critical lab and test results to the right clinician with date, time, recipient, delivery status, and read status auto-recorded to the EMR in accordance with Joint Commission requirements.

Next Steps for Getting Started

Explore how your team can combine real-time EHR data entry with seamless care coordination in one integrated solution by speaking with a clinical communication specialist.

 

Resources:
1. How real-time data can improve patient care, Nursing Times, Sep. 21, 2015: nursingtimes.net/clinical-archive/patient-safety/how-real-time-data-can-improve-patient-care-21-09-2015/
2. How Hospitalists Can Improve Efficiency on Inpatient Wards, The Hospitalist, Rajesh Chandra, MD, FHM, et. al., May 2014: the-hospitalist.org/hospitalist/article/126231/how-hospitalists-can-improve-efficiency-inpatient-wards
3. Electronic Nursing Documentation: Charting New Territory, Medscape, Sep. 12, 2013: medscape.com/viewarticle/810573

How Virtual Waiting Rooms Protect Patients, Staff, and Productivity

How Virtual Waiting Rooms Protect Patients, Staff, and Productivity

A traditional waiting room can be a melting pot for germs and bacteria. Learn how a virtual waiting room protects patients and staff by reducing their risk of exposure to infection. Possible side effects: more pleasant patient-provider encounters, increased patient and provider satisfaction, better adherence to social distancing best practices, and improved overall outcomes.

May 2020, 90% of patients globally reported that the quality of care was as good or better with the recent surge in virtual care than care quality before COVID-19.1

What is a “virtual waiting room”?

If you’ve been out to eat at a restaurant in the past few years, you may have noticed a change in the experience of waiting for a table. Rather than asking you to stay within earshot while you wait, today’s hostess will likely request your cell phone number and offer to text you when your table is ready.

The text-to-table process makes the entire experience feel more personal, comfortable, and customer-centric. That’s because waiting is less unpleasant when you are free to do what you want—where you want—until the moment your turn arrives. Now, the same experience has become essential in healthcare to minimize patient discomfort and protect public safety with social distancing.

A virtual waiting room (aka mobile waiting room, zero-contact waiting room, or curbside check-in) is a service that allows patients to check in using their mobile phone and notifies them through a direct text message when it is their turn to be seen by the doctor.

An ideal virtual waiting room serves two essential purposes:

  1. Giving in-person patients the freedom to wait for their turn privately in their car or wherever they choose, rather than being confined to a stuffy, crowded waiting room and risking exposure to new germs and potential illness.
  2. Facilitating a smooth check-in process for telehealth visits.

Both purposes improve the patient experience and encourage healthy practices.

Why are virtual waiting rooms essential for in-person patient visits?

31% of patients say they are uncomfortable visiting a doctor’s office and 42% are uncomfortable visiting a hospital.2

Traditional waiting rooms that require patients to touch shared surfaces and breathe shared air are both uncomfortable and unsafe in the current environment. Virtual waiting rooms serve the important health purpose of enabling social distancing, and they also enhance the patient experience.

Unlike a traditional waiting room, a virtual waiting room reduces the risk of patients (and staff) associating your organization with frustrating factors beyond your control, which may include pesky sounds, smells, other people, and even boredom. As demand rises for a safer, more comfortable healthcare experience, virtual waiting rooms are the key to getting patients in the door while increasing their odds of leaving satisfied.

How can virtual waiting rooms apply to video visits?

Ideally, the same virtual solution used to help manage in-person patient visits can be adapted to also queue up video visits, allowing providers and patients to indicate when they are ready.

What’s the best way to implement a virtual waiting room?

In short, work with what you’ve got. If you have a patient engagement solution that can also facilitate a virtual waiting room and video visits, talk to your vendor about the next steps for launching a virtual waiting room.

If you do not have a solution for two-way texting or video visits with patients, or if you are looking for a replacement/upgrade to your current system, focus on finding a solution that can do the following:

  • Automated Appointment Reminders to Patients
  • Pre-Appointment and Pre-Arrival Instructions to Patients
  • Patient Arrival Notification via Simple Text
  • Entry Notification and Office Navigation Guidance
  • HIPAA-Compliant Video Connection
  • Scheduled and On-the-Fly Video Visits
  • Connect Without Requiring App Downloads or Passwords
  • Caller ID Protection for Providers
  • 24/7 Connection

Here’s a streamlined patient experience with an organization using all of the above capabilities:

Key Benefits of an Integrated Virtual Waiting Room

Virtual waiting rooms are extremely beneficial to patients, staff, and organizations that implement them, especially when they are integrated with other patient engagement solutions, such as video visits and HIPAA-compliant messaging.

Some of the top benefits include:

  • Patient Protection and Safety
  • Increased Patient Satisfaction
  • Reduced Frustration for Patients and Staff
  • Efficient Patient Intake
  • Reduced No-Shows

 

Get Started Now to See Benefits Sooner

Give your patients a safer, easier solution for maintaining their healthcare with a user-friendly, integrated virtual waiting room. To see how it works, click below.

Resources:

  1. Virtual care here to stay, PharmaTimes, Brad Michel, Jul. 21, 2020: pharmatimes.com/web_exclusives/Virtual_care_here_to_stay_1345204
  2. Breakdown of Changes in Consumers’ Health Care Behavior During COVID-19—INFOGRAPHIC, Alliance of Community Health Plans (ACHP), May 21, 2020: achp.org/research-breakdown-of-changes-in-consumers-health-care-behavior-during-covid-19