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Alarm Fatigue

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Abby Sohn

on 17 December 2013

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Transcript of Alarm Fatigue

Alarm Fatigue
Creative CoLab - ARTS 492
Harding Coughter, Jeff Foster, Matt Rise, Jim Robb, Abigail Sohn, Jonathon Weller

Audible alarms
are part of every hospital ward
Alarms are frequent

per patient per day in critical care units
Alarm devices are not standardized
Flexible alarm settings allow inconsistent use between 85-99% of alarm signals do not require clinical intervention
low battery, poor adjustment, sensors mispositioned, etc.
Overwhelmed exposure may result in Alarm Fatigue

Introduction (cont.)
Recap - Emergency Medical Technicians (EMTs)

Problem Statement:
How can Google Glass improve communication between Emergency Departments and EMTs?

Main Priority:
Provide medical needs of sick or injured until transferred to hospital in most efficient way possible
Triage Nurses

What information do EMTs sometimes miss when focusing on taking care of a patient?

"It’s easy to get tunnel vision and miss clues around the scene."
If you have unresponsive person lying in their living room you
don't have time to look around
for pill bottles, needles, hazards, etc that might explain how they ended up there.

ex 2
: Traffic crashes, sometimes you are so caught up with your pt that you forget to note things like airbag deployment, seat belt use, dash/steering wheel deformity, and
when you get to the hospital the doc asks you about all those and you’re like f*ck I forgot to check.

Glass -
Capture information
Phone calls

Google Glass Experience
Explained by Virtual Harding
assault of alarm sounds that cause nurses to ignore and turn off alarms
Unsafe patient environment

John Hopkins Hospital
One 15-bed unit = average
alarms a day
(alarm every 90 seconds)

Nurses may turn down the volume, adjust settings, or turn it off

Alarms can go off up to an hour or two before being silenced

Joint Commission Report
- Matt

Top 10 critical hazards
since 2007(first in 2004)
85%-99% don’t require clinical intervention
98 Critical Alarm Fatigue study
80 resulted in death
13 permanent loss of function
Absent or inadequate alarm system (30)
Improper alarm setting (21)
Signal not audible in all areas (25)
Signs turned off (36)

Improper lead placement, no use of custom parameters, improper use of “silence” feature, low battery, unnecessary monitors

Nursing Student Interviews -
If we create a system that can categorize, prioritize and deliver high-priority messages to the nurse on call, then we can reduce alarm fatigue by delivering only the most important alarms to nurses on call and delivering the balance of alarms to support staff.

- Matt

Education, Training,
New alarm systems & Machines
Linking alarms to phones, pagers, smartphones
Hiring more nurses specifically to monitor alarms
Smart Monitors

What can Glass do to help?

Hands free
communication device
Capable of running software
Video and Audio Support
Wifi Enabled


Our team proposes a concept that will create system to:
Identify audible alarms
Sort by type and prioritize
Deliver sorted list to floor nurse station
Deliver only high-priority alarms to nurse on call via Google Glass or approved communication tools
Record all alarm events by date, time, category, response and action and to include this data as part of patient record to be included in HIPPA records

Concept (Cont.)

Our concept includes the following components:
Web-based national database of audible alarm signatures by product manufacturer, model and alarm type
Patient room audible sensor capable of receiving alarm sounds
Microprocessor client to receive audible signal, access database of alarms and identify alarm, date and time stamp alarm and pass alarm event to the alarm filter algorithm (Think SoundHound)
Alarm Filter Algorithm to sort the alarm event as directed by institutional, regulatory or industry category and pass alarm event to the communication module
Communication module to direct the alarm event to nurse on call via Google Glass or approved device or to the nurses station based on sorting criteria
Nurse on call or nurse station to receive alarm event and responds with action activity including date and time stamp. Action activity may include a tree of responses such as “Responding”, “Delay in responding” “Busy”, “Request assistance” or other approved communications.
Response includes visit to room to diagnose alarm, silence alarm and acknowledge response by team member “Alarm resolved” False Alarm” “Adjustment or Calibration required” “Request Service” etc., including date and time stamp

Moving Forward
1. Continue Researching
2. Reach out to MCV (interviews/experiment)
3. Backend development
4. UI/UX Design

3 ways to solve Problem

If not the solution, part of the solution

Alarm Fatigue Research
Would you enjoy hearing this all day at work?
1. Yes however, it really depends on the staff. Usually call bells go off and patient care techs are able to help the patients with their immediate needs; however, if the unit is short staffed the call bells/phones aren't answered as effectively.

2. Yes. During my capstone when I had down time, I was usually a call bell responder. Often times when I would report back to the nurse, she would seem frustrated due to the excessive ringing out.

3. Yes; it's very easy to get sidetracked with the number of patients/family members who call out because they rely on nurses as the voice between the patient and the physician.

4. I'm not sure how google glass would effectively solve this problem because I feel like it's not an issue of organization, but more so a problem on units who lack the nursing staff to accommodate for a full floor of patients.

5. Yes/no, we were taught about the nursing shortage that causes alarm fatigue but not necessarily alarm fatigue itself...
1. Yes

2. Yes. In some ways, you learn to ignore the beeping and alarms which is bad because then patients and issues are neglected. In another way, you can be so focused on the equipment that is beeping and alarming and will focus on that as opposed to caring for the patients.

3. Yes, but I'm not sure that there is any solution. Machines will also beep when bags of fluids are done (for ex.) and patients will always need something and hit the call button, so I'm not sure how this problem would be resolved.

4. Whether it's a google glass or other database that organized what alarm was what, it would be helpful. It would help nurses prioritize. For instance, if on the database it alerted: "Rm 4 IV pump beeping because fluid is done running and Rm 5 pt needs assistance to the restroom" it will be helpful to nurses to prioritize and not be overwhelmed by all the beeping and learn to address it, rather than ignore.

5. No.

Do you recognize alarm fatigue as a problem in the hospital?
Have you had or witnessed alarm fatigue affecting job performance?
Do you think it is necessary to find a solution to alarm fatigue related problems in the hospital?
If you had a hands free device (like google glass) that specified each alarm sound for you would you use it?
Were you taught about alarm fatigue in your education?
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