Attitudes and Practices Related to Clinical Alarms: A Follow-up Survey

Ruppel, Halley; Funk, Marjorie; Clark, J. Tobey; Gieras, Izabella; David, Yadin; Bauld, Thomas J.; Coss, Paul; Holland, Margaret L.

doi:10.4037/ajcc2018185

Cited by 31 publications

(26 citation statements)

References 25 publications

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“…Likewise, clinician response time grows with nonactionable alarms. 22 In a recent survey of attitudes and practices related to clinical alarms (survey included 30% respiratory therapists) Ruppel et al 37 reported a disappointing trend in the past 10 years, including worsening perceptions of nuisance alarms and more alarm-related adverse events, and many clinicians are more likely to agree nuisance alarms occur frequently and disrupt patient care than 10 years ago. Therefore, staff performance must be measured on the basis of the work environment, and options such as extending alarm delays may be worth the sacrifice in response time if the ultimate benefit to the patient is greater.…”

Section: Human Factorsmentioning

confidence: 99%

Alarm Strategies and Surveillance for Mechanical Ventilation

Walsh

Waugh

2020

Respir Care

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Clinical alarms, including those for mechanical ventilation, have been one of the leading causes of health technology hazards. It has been reported that < 15% of alarms studied rose to the level of being clinically relevant or actionable. Most alarms in health care, whether by default or intention, are set to a hypothetical average patient, which is essentially a one size fits most approach. A method of tuning to individual patient characteristics is possible, similar to the treatment philosophy of precision medicine. The excessive amount of alarms in a clinical environment is thought to be the largest contributing factor to alarm-related adverse events. All these factors come to bear on human perception and response to mechanical ventilation and clinical alarms. Observations of human response to stimuli suggest that response to alarms is closely matched to the perceived reliability and value of the alarm system. This paper provides a review examining vulnerabilities in the current management of mechanical ventilation alarms and summarizes best practices identified to help prevent patient injury. This review examines the factors that affect alarm utility and provides recommendations for applying research findings to improve safety for patients, clinician efficiency, and clinician well-being.

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Section: Human Factorsmentioning

confidence: 99%

Alarm Strategies and Surveillance for Mechanical Ventilation

Walsh

Waugh

2020

Respir Care

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“…Alarm fatigue refers to sensory overload from exposure to excessive alarms, resulting in desensitization to alarms and ignoring or dismissing alarms when they legitimately signal impending patient harm or death. 39 Combatting alarm fatigue is a top priority in surgical critical care. 40 CDS can improve care but also introduce errors, especially if the data in the CDS are not current.…”

Section: Leadership and Change Managementmentioning

confidence: 99%

The Value of the Surgeon Informatician

Zhao

Forsythe

Langerman

et al. 2020

Journal of Surgical Research

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Clinical informatics is an interdisciplinary specialty that leverages big data, health information technologies, and the science of biomedical informatics within clinical environments to improve quality and outcomes in the increasingly complex and often siloed health care systems. Core competencies of clinical informatics primarily focus on clinical decision making and care process improvement, health information systems, and leadership and change management. Although the broad relevance of clinical informatics is apparent, this review focuses on its application and pertinence to the discipline of surgery, which is less well defined. In doing so, we hope to highlight the importance of the surgeon informatician. Topics covered include electronic health records, clinical decision support systems, computerized order entry, data analytics, clinical documentation, information architectures, implementation science, quality improvement, simulation, education, and telemedicine. The formal pathway for surgeons to become clinical informaticians is also discussed.

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“…Alarm fatigue, cognitive overload and desensitization, and its consequences, fatal and near-fatal events as well as staff burnout and the "second-victim effect", are almost invariably described qualitatively. The work by Cho et al [13] targeting a scoring system for AF using on a questionnaire based on the HTF survey [14] was a first step to come to a quantification of alarm fatigue. There is, to the best of our knowledge, no published attempt to make the various facets of AF routinely measurable and comparable in a comprehensive manner, i.e.…”

Section: A the Measurability Gapmentioning

confidence: 99%

Measuring Alarm System Quality in ICUs (WIP)

Hüske-Kraus¹,

Wilken²,

Röhrig³

2018

EasyChair Preprints

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Despite a vast and growing number of publications on alarm fatigue there seem to be few attempts to quantify in a systematic way the root causes or consequences of alarm fatigue. The paper describes such an attempt, based on the notion of quality dimensions of an alarm system. The concept as well as concrete instances of these dimensions were developed in a scoping review including focus group interviews and subsequent iterative refinement workshops. The resulting model goes beyond currently used statistics for describing alarm system quality and appears to be useful for the construction of tools to support clinical users in the management of their alarm system.

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Attitudes and Practices Related to Clinical Alarms: A Follow-up Survey

Abstract: Although survey findings show disappointing trends in the past 10 years, including worsening perceptions of nuisance alarms and more alarm-related adverse events, the increase in alarm improvement initiatives is encouraging.

Cited by 31 publications

References 25 publications

Alarm Strategies and Surveillance for Mechanical Ventilation

Alarm Strategies and Surveillance for Mechanical Ventilation

The Value of the Surgeon Informatician

Measuring Alarm System Quality in ICUs (WIP)

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