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Wednesday, August 14, 2013

Alarm fatigue

A few years back my boss couldn't attend a "boss" conference, so he sent me.  The topic of discussion was "Alarm Fatigue."  The idea was that new studies were showing that many patients were suffering from "Alarm Fatigue," or fatigue caused by unnecessary and annoying alarm noise. A variety of companies showed their products, and how their alarms were manufactured so that they only went off when there was a true crisis, not just with any change.

I completely forgot about that conference until I read a recent editorial in the June, 2013, edition of RT: For Decision Makers in Respiratory Care called "Joint Commission Goal: Cause for Alarm."  He mentions a new initiative of the Joint Commission to make "the management of alarms one of their top priorities in 2014."

Back at the conference I attended various manufacturers showed off their products, and their alarms.  One was pulse oximeter that had an alarm that was smart, and that it would not go off every time the patient's pulse ox reading was, say, 88%.  It would only go off if the SpO2 was consistently low.  This way the patient doesn't get awakened every time he gets into a deep sleep and his sat dips ever so slightly.

These alarms are referred to as "smart alarms."  It made a lot of sense to me.  There will also be smart alarms on machines like ventilators so they don't alarm just because a patient takes a deep breath, or coughs, or gets excited and starts breathing fast.  I don't think you necessarily need a push by the government to do this, it should simply be common sense, or market driven.  

Another thing about "smart alarms" is that the "alarm" itself wasn't an annoying screech, but a soft, pleasant sound.  Now, I know no alarm will ever be totally "pleasing."  Yet I believe studies have been conducted regarding specific sounds, and cadences, that are both comforting to patients, and that still alert caregivers that an alarm is sounding.  

There are obvious needs for alarms, such as when a patient's ventilator circuit becomes disconnected.  But there are definitely a significant amount of "nuisance alarms" that could definitely be eliminated, or at the very least, reduced.  

Any progress in this regard will not only work to the satisfaction of patients, but might also work to reduce worker fatigue as well.  


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