Enhancing patient safety through decreasing non-actionable cardiac telemetry alarms and alarm fatigue
Project Background
Alarm fatigue is a national patient safety concern and the most common factor contributing to alarm-related incidents (The Joint Commission, 2013). The American Association of Critical Care Nurses identified approximately 80% to 99% of electrocardiographic monitor alarms are non-actionable to patients‚ physiological status (American Association of Critical Care Nurses, 2013). With the increasing number of clinical alarms and exposure to non-actionable alarms, nurses are exposed to the sensory overload that is leading to alarm fatigue.
Project Purpose
An evidence-based practice (EBP) quality improvement project was conducted in an academic hospital, 32-bed, adult cardiac step-down unit, to examine the impact of an evidence-based alarm management strategy on reducing the rate of non-actionable cardiac monitor alarms as well as reduce the level of alarm fatigue experienced by nurses, to enhance patient safety.
Project Methods
A pre-post intervention design was used to examine the effectiveness of a bundle intervention. The bundle included proper skin preparation for electrode placement, changing electrodes every 24 hours, and alarm customization. Measurement included: Rates of alarms and nurse‚ perceptions using a shortened version of the Healthcare Technology Foundation‚ Alarm Survey.
Project Outcomes
In two months, there was a decrease of 10 % in the non-actionable cardiac alarm rate after the intervention. Moreover, there were statistically significant changes in nurses‚ perceptions toward alarms. .
Project Implications
These evidence-based interventions propose simple and effective ways of reducing non-actionable cardiac alarms rate and which could reduce missed or delayed responses to actionable alarms and improve patient outcomes.
