Do you remember when car alarms first came out? When you heard that loud, insistent beep that signaled a potential crime in progress, you whipped your head around quickly to see what was happening. However, when you hear that same sound now, years after the first car alarms were designed, how do you react? Like most people, you probably are now just mildly annoyed at the sound, if you even hear it at all. While this desensitization is a normal result of constant exposure to alarms, a similar phenomenon known as alert fatigue represents a much more serious safety issues for healthcare workers in a hospital setting.
To illustrate the scope of the problem, one study performed at Johns Hopkins found that in one ICU unit, personnel were exposed to an average of 350 alarms per day, per bed. Other studies, however, have estimated that over 72 percent of alarms are actually false, compounding the problem unnecessarily. The sheer volume of alarms per day lead either to desensitization of staff, or tempt staff members to disable or mute alarms. Either of these results lead to endangerment of patients, and in worse case scenarios, even to patient death.
Because of the severity and widespread nature of alarm fatigue in healthcare settings across the country, The Joint Commission has identified it as a National Patient Safety Goal to be addressed in two phases. The first phase in 2014 was designed to heighten awareness of the potential risks of alarm fatigue. The second phase, due to be implemented in January 2016, introduces requirements to mitigate those risks.
What does this mean for hospital leaders? The expectation is that hospitals must develop and implement policies and procedures for managing alarms and provide appropriate training to staff regarding the purpose and proper operation of alarm systems for which they are responsible in the clinical setting.
It is recommended that some of the items for careful evaluation include: the devices and systems in place to manage alarms, the overall alarm system load, the parameters being monitored, staff levels and work patterns in alarm-sensitive areas, the physical layout of the unit utilizing the alarm system, and protocols and policies for alarm response. For such evaluation to be valid, it must take into account the input of workers actually impacted by the implementation of proposed policies. It is the healthcare professional in the trenches who can best evaluate the real-life implications of any comprehensive strategy to lessen the possibility of alarm fatigue.
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