Monday, January 27, 2014

Silencing Hospital Alarms

There's a great story on NPR today about a Boston hospital's success in reducing random alarm noise. In major part by giving nurses authority to adjust devices alarm settings based on what they knew of patients' conditions, a single hospital unit was able to reduce alarm noise from 90,000 beeps per week to only 10,000.

Why is that good? First, the incessant beeping of monitoring and other devices is very annoying to patients and staff alike. Second, too much beeping--about 350 beeps per patient-bed per day!--can induce alarm fatigue, causing staff to miss the really important signals when they occur. The Boston Globe attributed about 200 deaths over 5 years to alarm fatigue; the Joint Commission has reported 98 alarm-related sentinel events in a 3.5 year timespan, resulting in 80 deaths and over a dozen instances of permanent disability. The Joint Commission has therefore recently published new standards relating to alarm safety. It turns out that a lot of that beeping is really unnecessary; the Joint Commission has cited industry estimates that between 85 and 99 percent of hospital alarms aren't clinically actionable.

A paper on the Boston's hospital's alarm experience is here. A special alarm-safety issue of Horizons magazine (published by the Association for the Advancement of Medical Instrumentation) is here.

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