Alarms Fatigue: How are you planning to meet this NPSG?

1 TJC made alarms management a national patient safety goal. Also AACN came out with some suggestions to reduce alarms. fatigue.

National Patient Safety Goal on Alarm Management

How is your hospital planning to meet this NPSG? Who is leading the effort biomed or nursing? Last edit by Joe V on Jul 31, '13
Where are the suggestions to reduce alarm fatigue? Would appreciate reading those, thanks.

Here is the link: Alarm Management

Thank you!!Eta - oh darn I was hoping it was about bed alarms! But still a great read!

Why would bed alarms be treated any differently? Trying to understand. All of these alarms from IV Pump, to Low Battery on WoW to Fall risk devices contribute to alarm fatigue in my view.

Quote from Chinmay SinghWhy would bed alarms be treated any differently? Trying to understand. All of these alarms from IV Pump, to Low Battery on WoW to Fall risk devices contribute to alarm fatigue in my view.

To meet this, we are currently revamping our ECG monitoring policy. We SOOO over monitor. And I don't know if you have ever seen what a baby on ECG monitors looks like, but it's smack dab identical to VTACH. LOL! So we have huge amounts of monitor fatigue, but hopefully that will change with the new policies.

PedsRN- Who is sponsor of this project in your hospital? Nursing or Biomed?

Quote from ~PedsRN~To meet this, we are currently revamping our ECG monitoring policy. We SOOO over monitor. And I don't know if you have ever seen what a baby on ECG monitors looks like, but it's smack dab identical to VTACH. LOL! So we have huge amounts of monitor fatigue, but hopefully that will change with the new policies.

Why in the world don't manufacturers produce equipment that allows you to customize the alarm sounds??? Wouldn't it be great if you could differentiate "your" alarms from everyone else's? As an ICU nurse - you may just 'tune out' alarms because you think it belongs to someone else's patient or an unimportant function.... but if there was some way for alarms to be customized - Yeah!!

We are working on this as well, doing a bunch of things. One I can think of off the top of my head is customizing our alarms. For instance if I have a patient that is being treated for a-fib with RVR I'm going to turn off the a-fib alarm and irregular HR alarm on their tele. I already know their rhythm, I've seen the strips, taken the EKG, and, they're being treated. I don't need the alarm to tell me what I already know. Similarly I may turn off some of the low priority alarms like pair PVC, missed beat, multi focal PVC, etc. depending on the patient and the scenario. As long as this is done responsibly I think it's a really good way to cut down on noise pollution.

Sarakjp- That might be a good solution for you. But on a hospital level with multiple devices (IV, Enteral, Vital....) not to mention dying battery on a WoW, do you think some policy is needed? Maybe what you are doing is a "best practice" and others would benefit from it if it is a policy across hospital. In any case how will demonstrate what you described above to TJC when they come for audit and ask about this NPSG?

These are their specific guidelines:Ensure that there is a process for safe alarm management and response in areas identified by the organization as high risk.Prepare an inventory of alarm-equipped medical devices used in high-risk areas and for high-risk clinical conditions, and identify the default alarm settings and the limits appropriate for each care area.Establish guidelines for alarm settings on alarm-equipped medical devices used in high-risk areas and for high-risk clinical conditions; include identification of situations when alarm signals are not clinically necessary.Establish guidelines for tailoring alarm settings and limits for individual patients. The guidelines should address situations when limits can be modified to minimize alarm signals and the extent to which alarms can be modified to minimize alarm signals.Inspect, check and maintain alarm-equipped medical devices to provide for accurate and appropriate alarm settings, proper operation, and detectability. Base the frequency of these activities on criteria such as manufacturers’ recommendations, risk levels and current experience.The JC has two levels of requirements; Goals and Standards, as this still just a goal the requirements to show actual results are still minimal. Basically, you can get an "A" for effort. You do need to inventory everything that makes an alarm and list the defaults. You also need to show that Biomed has been performing routine quality checks. The big project involved is setting guidelines for when alarms can be adjusted and/or turned off. I find the culture of this varies widely from one facility to another. There are facilities where staff are very hesitant to aggressively limit alarms, it's these cultures that the JC surveyors will likely crack down on hard. Basically, any alarm should be providing information that is used for clinical decision making. If nobody cares that the patient had a pair, then that alarm should be off. The other acceptable reason for alarms is when a piece of equipment needs attention, and lack of attention could harm the patient, otherwise alarms should be turned off.