Reducing the Harm Associated with Clinical Alarm Systems: Meeting the Joint Commission National Patient Safety Goal.06.01.01 Performance Elements

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2016-12-16

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Problem: Clinicians and patients are vulnerable to alarm fatigue (AF). AF is a patient safety hazard and the leading cause of alarm-related sentinel events. The Joint Commission proclaimed reducing the harm associated with clinical alarm systems as a 2014 National Patient Safety Goal (NPSG.06.01.01). Aims/Objectives: Develop and implement a survey to assess AF amongst Intensive Care Unit (ICU) clinicians; Complete STEP 2 of NPSG.06.01.01 for an ICU which includes to “identify the most important alarm signals to manage…”. Design: Project design/methods were derived from an AF Conceptual Framework and the Iowa Model. Participants: Convenience sample of 28 ICU clinicians. Setting: An 11-bed medical-surgical ICU located in a 276 bed community hospital in Hawaii. Data Collection: NPSG.06.01.01 Clinical Alarm Management Questionnaire. Participants completed the survey electronically/anonymously via “Survey Monkey”. Electronic databases used for a literature review included Cochrane Reviews, National Guideline Clearinghouse, Agency for Healthcare Research and Quality, Dynamed, PubMed, CINAHL, MEDLINE. Data Analysis: “Survey Monkey” was used for descriptive/quantitative analysis of demographic and likert-scale survey measures. There was one qualitative survey response. Results: The majority of participants appear to be affected by AF on 78% of the AF survey measures. Thus, AF is likely a problem in this ICU. Additionally, results indicate that physiologic monitor alarms are most important to manage followed by ventilator, IV infusion pump, and bed exit alarms. Recommendations: Management can use these results when proceeding to NPSG.06.01.01 STEP 3 and STEP 4, which include establishing policies for managing alarms identified in STEP 2 and educating staff.

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Clinical Alarm Systems, Alarm Fatigue, Patient Safety

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