Combating Alarm Fatigue: The Quest for More Accurate and Safer Clinical Monitoring Equipment

Abstract

As the demand for health-care services continues to increase, clinically efficient and cost-effective patient monitoring takes on a critically important role. Key considerations inherent to this area of concern include patient safety, reliability, ease of use, and cost containment. Unfortunately, even the most modern patient monitoring systems carry significant drawbacks that limit their effectiveness and/or applicability. Major opportunities for improvement in both equipment design and monitor utilization have been identified, including the presence of excessive false and nuisance alarms. When poorly optimized, clinical alarm activity can affect patient safety and may have a negative impact on care providers, leading to inappropriate alarm response time due to the so-called alarm fatigue (AF). Ultimately, consequences of AF include missed alerts of clinical significance, with substantial risk for patient harm and potentially fatal outcomes. Targeted quality improvement initiatives and staff training, as well as the proactive incorporation of technological improvements, are the best approaches to address key barriers to the optimal utilization of clinical alarms, AF reduction, better patient care, and improved provider job satisfaction.

Evaluating the Alarm Fatigue and its Associated Factors among Clinicians in Critical Care Units

“…The fatigue is a domain of mental health that is very crucial to health related quality of life of the healthcare providers [23]. In the long-term, fatigue can also affect staff health and morale, with effects on cardiovascular outcomes, depression [26], leading to stress [1], [17], and even "burn-out" [17], [26], [27]. Furthermore, stress certainly influences AF by forcing healthcare providers to instantaneously adjust their work activities (and priorities) according to perceived importance of near constant clinical alarm activity [17].…”

“…The Health and Safety Executive in the United Kingdom, when discussing fatigue management, suggests that if shifts are a maximum of 8 hours, they require special attention and high concentration [26]. Reducing the noise at night results in better sleep for staff and patients [17].…”

“…Alarm fatigue is a kind of human error [3], [16]. Ultimately, consequences of AF include missed alerts of clinical significance, with substantial risk for patient harm and potentially fatal outcomes [15], [17]. Alarm fatigue may also cause a 'second victim' effect.…”

“…Section 2 included questions about monitoring equipment and alarm management. We assessed data about the rate of non-actionable alarms (false, technical or nuisance alarms) [17]. Also, data of types of medical devices and alarms that mostly emit irrelevant alarms causing highest alarm fatigue were collected.…”

A Multicenter Validation Study of the Deep Learning-based Early Warning Score for Predicting in-hospital Cardiac Arrest in Patients Admitted to General Wards

“…A false alarm that does not need to lead to next level of treatment could exhaust RRS staff, causing alarm fatigue and leading to inappropriate alarm responses. Consequently, excessive false alarms and alarm fatigue can result in staff desensitization and missed responses to alerts of clinical signi cance, putting patient safety and quality of care at substantial risk [24]. Therefore, an ideal EWS should have high sensitivity and a low false alarm rate, so we compared the alarm rate with the MACPD according to the same sensitivity level.…”