Reducing Alarm Fatigue: A Modest Plan
Alarm fatigue and its potential dangers have gained prominence in the last few years thanks largely to the dogged work of front-line healthcare professionals and some solid reporting in the media, particularly the Boston Globe.
This increased awareness has brought with it the acknowledgement that while alarm fatigue may be simple to understand, it also raises challenging questions. For example, if there are too many alarms, which beeps and bells are prioritized? Which can be ignored? Which are redundant? And most worrisome: What if a clinician ignores the wrong alarm? And who gets the blame?
Maria Cvach, RN, the assistant director of nursing clinical standards at The Johns Hopkins Hospital, has led the acclaimed Baltimore hospital's award-winning alarm improvement efforts since 2006. She says alarm fatigue has grown because medical devices and monitors found at hospital bedsides are not interoperable.
"Each device functions as its own little alerting system," Cvach tells me. "We work in a world where equipment is isolated, and as a nurse you have to rely on getting rid of the nuisance alarms and trying to extrapolate out of that the important alarms. It is hard to do when you have thousands of alarms a day from every device in a patient's room. In an ICU you may have seven or eight pieces of equipment that alarm. How does a nurse figure that out?"