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. 


Raja Issa

Graduation Date

April, 2018


alarm fatigue
alarm management
cardiac monitoring
quality improvement
Model for Improvement
Synergy Model.