Survey Finds Alarm Fatigue a Major Concern at Hospitals

"Alarm fatigue"—which can lead to serious and sometimes fatal consequence for patients—is rated as a top concern by 19 out of every 20 hospitals in the United States, according to a new national survey presented recently at the Society for Technology in Anesthesia (STA) annual meeting.

"Hospitals are greatly concerned about alarm fatigue because it interferes with patient safety, and it exposes patients—and the hospitals themselves—to grave harm," said Michael Wong, executive director of the Physician-Patient Alliance for Health & Safety, who presented alarm fatigue results from the First National Survey of Patient-Controlled Analgesia Practices at the STA meeting.

Alarm fatigue occurs when hospital staffs become desensitized to the cacophony of patient alarms that bombards them each day. This can lead to improper responses, such as turning down alarm volumes, disabling alarms, or adjusting alarm settings beyond safety limits.

"A sample from the intensive care unit at The John Hopkins Hospital shows an average of 350 alarms per bed, per day," Wong said. "That translates into thousands of alarms per unit and tens of thousands of alarms per hospital each and every day."

To reduce alarm fatigue and improve alarm management, hospitals need to develop a systemic approach that considers such factors as staffing patterns, care models, architectural layouts, patient populations, and how responsibilities are delineated, Wong said.

"Among the most critical considerations are the capabilities and configuration of technology," he said, pointing out that nearly nine of ten (87.8%) of the surveyed hospitals believe that reducing false alarms would increase their use of patient monitoring devices that incorporate capnography and/or pulse oximetry.

The survey also found that:

• Of hospitals that currently monitor some or all of their patients with pulse oximetry or capnography, more than 65% have experienced positive results—either in terms of a reduction of overall adverse events or of costs and expenses. The other 35% of those that monitor say it is "too early to determine or have not determined."
• Hospitals using smart pumps with integrated end tidal monitoring were almost three times more likely to have had a reduction in adverse events or a return on investment in terms of a reduction in costs and expenses.

"What's also notable is that a majority of the surveyed hospitals—70% of them, in fact—expressed a need for a single assessment indicator," Wong said. "They believe that a single indicator to assess the patient's pulse rate, exhaled carbon dioxide, respiratory rate, and oxygenation would be crucial in reducing alarm fatigue and improving alarm management."

The national survey comes at a time when alarm fatigue is gaining awareness in both the public and throughout the health care industry.  The issue has become so pervasive that it is a National Patient Safety Goal of The Joint Commission.

"I think we all agree that one death resulting from alarm fatigue is one too many—and that's why it's encouraging to see that hospitals are taking proactive steps to improve alarm management," Wong said.

Source: Physician-Patient Alliance for Health & Safety