Excessive alarms are a threat to patient safety. New guidelines offer strategies to improve alarm management.
Nurses working in acute-care settings are all too familiar with alarm fatigue, which occurs when clinicians are exposed to excessive amounts of alarms, particularly false and clinically insignificant alarms. In fact, studies estimate that approximately 90% of alarms in various critical care settings are either false or clinically irrelevant.
This poses a significant patient safety risk, as the desensitization to alarms can cause delays in clinician response time or may be missed altogether, which could lead to patient harm.
To help address this issue, the American Association of Critical-Care Nurses released a Practice Alert at the end of May that outlines the evidence-based practices to reduce false or nonactionable clinical alarms and prevent alarm fatigue, with specific guidelines for both bedside caregivers and nurse leaders.
“This practice alert takes what is known about alarm management and puts it into action-oriented strategies to help nurses provide the safest patient care possible when managing clinical alarms in acute and critical care environments,” said Linda Bell, MSN, RN, AACN clinical practice specialist. “The issue of alarm fatigue can most effectively be addressed, and eventually eliminated, by working with the people closest to the patient and those who support the needs of the patient.”
For nurse leaders, the main takeaways of the alert are:
- Organize an interprofessional alarm management team. The team should be made up of stakeholders from the clinical, technical, and information technology communities to gather alarm data and develop policies that can help reduce alarms.
- Develop unit-specific default parameters and alarm management policies. Each hospital unit is different, so try to come up with policies that better fit your patient population. Changing the unit’s alarm default settings based on the unit’s expertise can help decrease insignificant alarms, the researchers found.
- Provide ongoing education on monitoring systems and alarm management for unit staff. As with most issues on the nursing unit, continuing to educate staff is a crucial component to ongoing success. Education increases understanding of how monitoring systems and their alarms should be managed, which will lead to more individualized settings at the outset, reducing the overall number of false alarms.
- Develop policies/procedures for monitoring only those patients with clinical indications for monitoring. The interprofessional team should determine which patients in a population or care unit should be monitored and under what parameters. Reducing the number of unnecessary monitors can significantly decrease the number of insignificant alarms.