Stimulus-response time to invasive blood pressure alarms: implications for the safety of critical-care patients

Pergher, Adele Kuckartz; Silva, Roberto Carlos Lyra da

doi:10.1590/1983-1447.2014.02.43715

Cited by 6 publications

(11 citation statements)

References 8 publications

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“…Characteristics of included studies are shown in Table . Of the 24 observational studies, 15 included adult patients, 7 included pediatric patients, and 2 included both adult and pediatric patients . All were single‐hospital studies, except for 1 study by Chambrin and colleagues that included 5 sites.…”

Section: Resultsmentioning

confidence: 99%

“…The number of patient‐hours examined in each study ranged from 60 to 113,880 . Hospital settings included ICUs (n = 16), general wards (n = 5), EDs (n = 2), postanesthesia care unit (PACU) (n = 1), and cardiac care unit (CCU) (n = 1) . Studies varied in the type of physiologic signals recorded and data collection methods, ranging from direct observation by a nurse who was simultaneously caring for patients to video recording with expert review .…”

Section: Resultsmentioning

confidence: 99%

“…Whereas 9 studies addressed response time, only 2 evaluated the relationship between alarm burden and nurse response time . Voepel‐Lewis and colleagues found that nurse responses were slower to patients with the highest quartile of alarms (57.6 seconds) compared to those with the lowest (45.4 seconds) or medium (42.3 seconds) quartiles of alarms on an adult ward ( P = 0.046).…”

Section: Resultsmentioning

confidence: 99%

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Systematic Review of Physiologic Monitor Alarm Characteristics and Pragmatic Interventions to Reduce Alarm Frequency

Paine

Goel

Ely

et al. 2015

Journal of Hospital Medicine

143

131

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Background Alarm fatigue from frequent nonactionable physiologic monitor alarms is frequently named as a threat to patient safety. Purpose To critically examine the available literature relevant to alarm fatigue. Data Sources Articles published in English, Spanish, or French between January 1980 and April 2015 indexed in PubMed, CINAHL, Scopus, Cochrane Library, Google Scholar, and ClinicalTrials.gov. Study Selection Articles focused on hospital physiologic monitor alarms addressing any of the following: 1) the proportion of alarms that are actionable, 2) the relationship between alarm exposure and nurse response time, and 3) the effectiveness of interventions in reducing alarm frequency. Data Extraction We extracted data on setting, collection methods, proportion of alarms determined to be actionable, nurse response time, and associations between interventions and alarm rates. Data Synthesis Our search produced 24 observational studies focused on alarm characteristics and response time and 8 studies evaluating interventions. Actionable alarm proportion ranged from <1% to 36% across a range of hospital settings. Two studies showed relationships between high alarm exposure and longer nurse response time. Most intervention studies included multiple components implemented simultaneously. While studies varied widely, and many had high risk of bias, promising but still unproven interventions include widening alarm parameters, instituting alarm delays, and using disposable electrocardiographic wires or frequently changed electrocardiographic electrodes. Conclusions Physiologic monitor alarms are commonly nonactionable, and evidence supporting the concept of alarm fatigue is emerging. Several interventions have the potential to reduce alarms safely, but more rigorously designed studies with attention to possible unintended consequences are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Systematic Review of Physiologic Monitor Alarm Characteristics and Pragmatic Interventions to Reduce Alarm Frequency

Paine

Goel

Ely

et al. 2015

Journal of Hospital Medicine

143

131

View full text Add to dashboard Cite

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“…The remaining 55 alarms were defined as fatigued by the authors, because they sounded for more than 10 minutes without response from profissionais. 24 Therefore, with regard to violations, understanding the social context is important to understand motivations that led to the violation behavior. This calls attention to organizational culture and the behavior of those who are involved.…”

Section: Discussionmentioning

confidence: 99%

Violations of Nurses in the Use of Equipment in Intensive Care

Ribeiro

Silva²,

Ferreira³

et al. 2017

Texto contexto - enferm.

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Objective: to identify situations of violation in the use of equipment by nurses in the intensive care unit and analyze their implications on patient safety. Method: a descriptive field study with qualitative approach was carried out from March to December 2014, with the use of James Reason's violation concept. The participants were nurses from the day shift, working in direct care at an intensive care unit of a federal hospital. Data production was carried out through systematic observation and interviews, and were analyzed based on thick description of scenes and content of responses. Results: violations in planning care regarding the checking of the equipment functioning before its use and alarms were found, when nurses disconnect them to reduce the effects caused by the overload of noise on the team. Conclusion: the situations reported compromise safety and cause serious risks to patients. Therefore, implementation of strategies to promote a safety culture is required.

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“…Many of these alarms are considered false, with no clinical meaning, and contribute to alarm fatigue, the desensitization of the team for important clinical alarms manifested in behaviors such as ignoring them, silencing them, turning them off or turning down their volume. This scenario has raised the interest of researchers to measure the time between stimulus and response of ICU professionals to equipment alarms (25)(26) .…”

Section: Discussionmentioning

confidence: 99%