• Stella Chiu Nguyen, Sukardi Suba, Xiao Hu, and Michele M Pelter.
• Stella Chiu Nguyen is a registered nurse in the radiology department at Stanford Healthcare, Palo Alto, California. At the time of writing this article, Ms Nguyen was a registered nurse in the emergency department and a Master's student at University of California San Francisco (UCSF) Health, San Francisco, California. Sukardi Suba is a doctoral student and an ECG monitoring predoctoral fellow in the Department of Physiological Nursing, UCSF School of Nursing. Xiao Hu is a biomedical engineer in the UCSF School of Nursing and the Institute for Computational Health Sciences, UCSF-UC Berkeley Graduate Program in Bioengineering, San Francisco. Michele M. Pelter is an assistant professor and the Director of the ECG Monitoring Research Lab, UCSF School of Nursing.
• Crit Care Nurse. 2020 Apr 1; 40 (2): 14-23.

BackgroundPatients with both true and false arrhythmia alarms pose a challenge because true alarms might be buried among a large number of false alarms, leading to missed true events.ObjectiveTo determine (1) the frequency of patients with both true and false arrhythmia alarms; (2) patient, clinical, and electrocardiographic characteristics associated with both true and false alarms; and (3) the frequency and types of true and false arrhythmia alarms.MethodsThis was a secondary analysis using data from an alarm study conducted at a tertiary academic medical center.ResultsOf 461 intensive care unit patients, 211 (46%) had no arrhythmia alarms, 12 (3%) had only true alarms, 167 (36%) had only false alarms, and 71 (15%) had both true and false alarms. Ventricular pacemaker, altered mental status, mechanical ventilation, and cardiac intensive care unit admission were present more often in patients with both true and false alarms than among other patients (P < .001). Intensive care unit stays were longer in patients with only false alarms (mean [SD], 106 [162] hours) and those with both true and false alarms (mean [SD], 208 [333] hours) than in other patients. Accelerated ventricular rhythm was the most common alarm type (37%).ConclusionsAn awareness of factors associated with arrhythmia alarms might aid in developing solutions to decrease alarm fatigue. To improve detection of true alarms, further research is needed to build and test electrocardiographic algorithms that adjust for clinical and electrocardiographic characteristics associated with false alarms.©2020 American Association of Critical-Care Nurses.

22 keywords...

hide…