Student data collection of alarm patterns in clinical settings

.....clinician responses to alarms? For example: Physical barriers, physical layout of the unit, RN-pt ratio.

The observed influences include the type of alarm, such as whether it was a bed or bathroom alarm versus a technology alarm coming from something like the IV pump.

2. How, as a student, are you educated about alarms and your response to them? How might education regarding the various patient alarms be an issue associated with alarm response?

I have done some research on the clinical implications of alarms and alarm fatigue. For example, Cyach, et al. (n.d.) found that too many alarms causes alarm fatigue, and also creates a "false sense of security," (p. 5). The researchers also found that staff is sometimes not educated about the different types of alarms and what they mean.

3. Who is responsible for alarm response?

The delegation of authority for responses will vary from case to case. In the clinical setting in my unit, which I observed for this analysis, all nurses on duty were responsible. However, some nurses with areas of specialization would attend to additional alarms other than the general ones of the bed alarm, the bathroom alarm, and the IV alarm.

4. Based on your observations, why are alarms ignored?

As Cyach et al. (n.d.) point out, alarms are most often ignored when the nurses become fatigued to them, when the alarms go off unnecessarily (false alarms) or when a problematic patient presses their bed alarm frequently as a behavioral problem. Other causes of ignoring alarm is the perception that the alarm has been triggered by an equipment malfunction. Another issue is the "false sense of security" that Cyach et al. (n.d.) notice in that nurses do not hurry to address the issue because they do not believe it to be serious (p. 5).

5. Who is responsible for testing and managing alarms on your unit? How are limits set on alarms?

Technicians come and test the equipment when there is a perceived malfunction. The head nurse in the unit understands some of the equipment, especially the IV units, and manages those alarms. Limits are set by the technician, but with the input of the nurse on hand.

6. What is a nuisance alarm? How did the alarm become a nuisance alarm? What is the danger in classifying an alarm as a nuisance alarm?

A nuisance alarm is a false alarm of any type. There are many types of nuisance alarms, some of which have their basis in a technology malfunction and others in the settings of the alarm. Some are from individuals who do not understand the equipment properly. The danger in misclassifying some alarms as being nuisance alarms is that they may actually be real alarms, and if they are classified as a nuisance, they might be ignored, impacting patient safety.

7. If asked by a patient about a specific alarm, how would you respond? How does your response play a role in your patient & family's perception of their care?

I would talk honestly and openly with the patient, in the spirit of caring because the patient has the right to know about how the alarm system works, and what each alarm means. In fact, I believe this will improve patient safety as they will understand the equipment and procedures.

8. What is meant by alarm prioritization? How are alarms prioritized on your unit?

Prioritization of alarms helps nurses to understand which alarms indicate more serious issues. This procedure is used on my unit, as some equipment is set to different levels because it might indicate a more severe issue than simply patient discomfort.

9. What did you learn about the impact of alarm safety on patient safety?

I have learned that alarm safety is directly related to patient safety. When alarms are used properly, patient safety is ensured.

10. How is alarm response a nursing/health issue?

Alarm management is integral to healthcare and nursing, because the healthcare environment is technology rich. The alarms should be viewed as our helpers, and not as pests.

11. Who is responsible for responding to alarms?

All nurses are responsible for responding to alarms in one way or another.

12. Did you find this learning activity to be useful?

I did find this activity to be useful, as it makes me think more critically about the importance of alarm management.

References

Cvach, M., et al. (n.d.). Clinical alarms and the impact on patient safety. Retrieved online: http://www.premiersafetyinstitute.org/wp-content/uploads/Initiatives-in-Safe-Pt-Care-Alarm-safety.pdf