• Worldviews Evid Based Nurs · Aug 2017

    An Evidence-Based Approach to Reducing Cardiac Telemetry Alarm Fatigue.

    • Ekta Srinivasa, Jaspreet Mankoo, and Charles Kerr.
    • Clinical Resource Nurse for Acute Care, VA Boston Healthcare System, West Roxbury, MA, USA, Curry College Capstone Project, Curry College, Milton, MA, USA.
    • Worldviews Evid Based Nurs. 2017 Aug 1; 14 (4): 265-273.

    BackgroundIt is estimated that between 80% and 99% of alarms in the clinical areas are in actionable alarms (Gross, Dahl, & Nielson). Alarm management is one of the Joint Commission's National Patient Safety Goals (2014) because sentinel events have directly been linked to the devices generating these alarms.PurposeAt an acute care facility in Boston, a multidisciplinary team consisting of Nursing, Biomedical Engineers, Patient Safety and Providers was formed to conduct a pilot study on the state of telemetry alarms on a surgical floor.MethodsAn evidence-based approach was taken utilizing Philips Real-time data exporter alarms tracking software to capture all telemetry alarms during a 43-day time span. Likewise, noise meters were placed near telemetry alarm speakers to track decibel levels within the aforementioned timeframe for 21 days. Analysis of the data showed that clinically insignificant Premature Ventricular Contractions (PVC) alarms accounted for more than 40% of all alarms in the unit within the time span, while also contributing to an average noise level of 58.49 dB. In response to the data, the interdisciplinary team approved to permanently default the settings for PAIR PVC, MULTIFORM PVC, and RUN PVC alarms to off.ResultsThe results showed a 54% decrease in the rate of alarms per bed per day, and an average noise reduction of 2.3 dB between the two selected noise measurement areas.Linking Evidence To ActionOrganizing a multidisciplinary team provides an effective framework toward analyzing and addressing cardiac telemetry alarm fatigue. Looking at quantitative datasets for clinical care areas through various lenses helps identify opportunities for improvement in regards to highlighting alarms that are not actionable. Pilot changes to alarm parameters can be tested for their environmental impact in the care area.© 2017 Sigma Theta Tau International.

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