Abstract 13205: Mitigating Alarm Fatigue and Improving the Care Provider, Patient, and Family Experience Through Reduction in Non-Actionable Bedside Alarms

• Published in: Circulation (New York, N.Y.) N.Y.), 2022-11, Vol.146 (Suppl_1), p.A13205-A13205
• Main Authors: Yang, Jeffrey K, Su, Felice, DeSousa, Carlos, Graber, Anna, Hedlin, Haley, Feehan, Shannon, Graves, Angela, Palmquist, Andrew, Madsen, Nicolas, Cable, Rhonda, Kipps, Alaina
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.146.suppl_1.13205

IntroductionThe burden of bedside alarms is a well-established patient safety hazard with >85% of alarms in ICU settings considered non-actionable or “false alarms”. Healthcare providers risk developing alarm fatigue with potential for prolonged response times and silencing of clinically meaningful alarms. Additionally, alarms disrupt care and cause stress for patients and families. HypothesisCreating conditional alarm triggers for bedside monitors can decrease the frequency of non-actionable alarms without compromising safety. The decreased burden of alarms on nurses, patients, and families may promote increased satisfaction. MethodsSingle center, quality improvement initiative in a 26-bed cardiac acute care unit and 36-bed pediatric ICU, modeled after successful iterative effort at another tertiary children’s hospital. After 1 month pre-intervention observation of bedside monitor alarm burden, monitors were programmed with hierarchical time delay and conditional pulse oximetry, respiratory rate, and premature ventricular contractions alarm triggers. Bedside alarms were tallied for 1-month follow-up. The primary outcome was alarms per monitored patient day (MPD). ResultsA total of 1394 and 776 MPD were evaluated in the pre- and post-intervention periods, respectively. The median number of cardiorespiratory monitor alarms per MPD decreased by 73% (15 to 4, p < 0.001) in both acute care and ICU. Alarm burden in RR, SpO2, and PVC categories also decreased. No increase in frequency of rapid response or code events occurred in either unit. Nursing surveys (n=253) reported positive trends of more manageable alarm burden and decreased perceived number of alarms. Family surveys (n=160), however, reported decreased sleep quality and increased perceived alarms. ConclusionsImplemented changes to bedside monitor alarm conditions decreased total alarm frequency in both cardiac acute care and pediatric ICU without compromising safety.