Changes to Combat Alarm Fatigue

Interdisciplinary Consideration -- Alarm Fatigue

Interdisciplinary Consideration: Alarm Fatigue

Alarm fatigue is a very real problem for a number of people in various disciplines. It occurs when alarms go off so much that people begin to tune them out. That could mean ignoring something that would be very important to note, and could end up putting patients at risk of serious injury and even death. Two of the disciplines where alarm fatigue is a serious problem include nursing and surgery. In both areas there are many alarms going off, alerting medical personnel of various conditions. However, "alarms" may not really be the right word for these sounds. A number of the noises that occur are more closely based on notifying people of something, as opposed to an actual alarm that is set to indicate a true emergency. Clearly, changes need to be made that can help both nurses and surgeons know when they are being notified of something and when there is a true emergency to which they must immediately attend. Without a better understanding of the reasons behind alarm fatigue, it is very difficult to suggest options to help combat it.

Combating alarm fatigue is extremely important, and has to be addressed sooner as opposed to later. Without doing that, the medical personnel on whom patients rely will be putting those same patients at risk, and not helping them to heal and improve so they can leave the hospital. Terminal patients who need pain medication and other types of related care may also go too long without getting what they really need, which can severely reduce the quality of the time they have left. In some cases, patients have died because nurses have ignored alarms for too long and have not checked on the patients properly or in a timely manner. In the surgical suite, the surgeons have others to help advise them regarding alarms, but that does not mean the entire surgical team cannot get caught up in alarm fatigue.

However, planned changes that will impact the disciplines mentioned previously -- especially nursing -- involve the way the alarms actually sound. Studies have shown that the noises are tuned out because they can seem "unfriendly" and because they are all alike in many ways. The tones, volume levels, and durations of the alarms are all too close together to be valuable when it comes to properly distinguishing them from one another. That is a large part of why they are tuned out by nurses, surgeons, and other medical personnel. It is not that these people do not see the importance of the alarms, but only that they lose focus on them because the alarms all blend together into a cacophony of noise that has to be tuned out in order to function in the fast-paced medical environment. Since the sounds of the alarms now have to be tuned out, it stands to reason that the sounds must be changed. By providing nurses and surgeons with alarm sounds that are different from one another and from what is currently used, the odds of combating alarm fatigue increase.

Changing the alarms over will take some time, and will also cost money. Machines that sound different from those that are currently used will be needed, and these machines will have to be understood by those who will be using them. If the people who use the new machines and hear the new alarms are not properly trained, they could end up ignoring alarms not because of fatigue, but because they simply did not realize the alarms were going off or what they were supposed to mean. There will be a learning curve, but that is true anytime there is a change in medical equipment. This is nothing new, and will not be difficult to address as long as the training is properly done and consistent. A time period during which the new alarms are merged with the old ones will also be needed, and that could lead to confusion. It will be necessary to carefully monitor this change-over period, in order to make sure patients do not slip through the cracks.

There will be conflicts, problems, and aggravation with the new plan at first. This is expected, because change is never easy. This is also a very large change, in that it is adjusting something that nurses and surgeons are used to hearing and have been working with for a very long time. Additionally, there may be a conflict between the nurses and the surgeons, if the alarms and their meaning are not the same across both of the disciplines. The more uniform things are kept, the more likely it will be that the change-over will be successful. Without a successful change-over from the older alarms to the newer ones, it could be difficult for nurses and surgeons to do their jobs correctly and help ensure maximum value to the patient when it comes to receiving the proper level of care. Caring for patients -- through medical procedures or aftercare -- can be very difficult, and it is a time-consuming and stressful job. It is not surprising that alarm fatigue sets in and people tune out the alarms that are going off all around them. They may feel this is necessary if they are to get any work done.