RN-MSN – Chief Nursing Officer
Cardiac alarms. Bed alarms. Intravenous pumps that have completed medications or possibly have an occlusion. Patient call bells. Low oxygen sensor alarms. Ventilators with varying alarm indicators. Television alarms. Personal technological devices with several alarms.
Nurses continually face and hear numerous alarms in a day’s shift. To some, the alarms become mundane, and the nurses become desensitized to the alarms.
The phenomenon that some nurses experience with this type of action is known as alarm fatigue. It is extremely important for nurses to be aware of the following when dealing with potential alarm fatigue:
Alarm fatigue is way too real and frightening for nurses in healthcare and typically occurs when nurses and clinicians experience high exposure to medical alarms, which in turn can cause desensitization leading to missed alarms or delayed responses. Alarms are omnipresent in a healthcare setting and serve to inform medical personnel of changes that occur involving certain parameters as well as any malfunctioning of equipment.
According to a study conducted in 2012, the average number of alarms generated per patient that a nurse attends during a 24-hour time period averages around 150 to 400 alarms.
As one can understand, this can lead to sensory overload due to the excessive number of alarms and ultimately affects nurses by creating delayed reactions to the alarms or by ignoring them completely. Both of these factors can lead to huge patient safety issues if desensitization takes place.
Often times, alarm settings specific to each individual’s needs are not adjusted accordingly which result in frequent false alarms, the inability of staff to adequately detect where the alarms are coming from, and sometimes the staff are inadequately trained to effectively monitor the alarms. All of the above factors play an important role in the signs of alarm fatigue that seem to be increasing among nurses in healthcare.
There are numerous dangers associated with alarm fatigue and each facility must recognize these dangers in order to act promptly and efficiently to reduce the dangers that can occur.
The consequences of alarm fatigue involve the following:
The occurrence of alarm fatigue seems to be occurring too often and hospitals and facilities must prioritize immediate implementation of intervention. Assuming that an alarm is false does nothing except place the patient in harm’s way and can lead to terrible medical mistakes.
Nurses and healthcare providers can also develop employee burnout and a decreased desire to work in an environment that involves excessive and continuous overstimulation.
The Joint Commission encourages healthcare systems to implement policies to decrease the burden of unnecessary alarms for the staff.
To accomplish this, the following are recommended by the NCH Healthcare System:
The dangers of alarm fatigue must be identified promptly and actions must be implemented as soon as possible in an effort to maintain patient safety and decease burnout among the employees.
It is important to acknowledge that while there is no universal solution to alarm fatigue, approaches must be made to combat it. Standardization can be customized for specific units and certain groups of patients.
The Association for the Advancement of Medical Instrumentation formulated the following recommendations to overcome alarm fatigue:
While nurses and healthcare employees are fully aware that alarms are unavoidable in hospital settings, it is of equal importance to understand the necessity of developing effective strategies to manage alarms. Nursing personnel can easily feel overburdened and overstimulated with an excessive number of medical duties along with a continuous wave of alarms.
Many nurses also do not realize the importance or the need for education regarding alarms which is a necessary element of any alarm management strategy system. Many hospitals and facilities do not assess the level of alarm fatigue and this is an area that needs to be focused on more intently.
By doing so, it would assist in providing safety to both patients and nursing personnel and would assist in verifying the effectiveness of strategies that are introduced. Alarm fatigue is not an issue that is only present in large healthcare systems, but is noted in both inpatient and outpatient facilities.
The chances are high that nurses exposed to the sounds of alarms beeping all day develop a sense of desensitization which could potentially have a detrimental effect on patient safety. Alarms are meant to be used in a purposeful way to save lives or to reverse an issue before it’s too late. Nurses with alarm fatigue are at risk for falling prey to this phenomenon and it is important to assess this factor among each patient/nurse to help eliminate the issue in an efficient manner.
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