Effectiveness of application of a manual for improvement of alarms management by nurses in Intensive Care Units
DOI:
https://doi.org/10.17533/udea.iee.v39n2e11Keywords:
clinical alarms, monitoring, intensive care units, observation, nursesAbstract
Objective. To evaluate the effects of application of a manual on the improvement of alarms management in Intensive Care Units (ICU).
Methods. This quasi-experimental study evaluated the effectiveness of the introduction into of a manual for alarm management and control in the ICU of a hospital in southeastern Iran. The intervention was a 4-hour workshop was on topics related to the adverse effects of alarms, standardization of ECG, oxygen saturation and blood pressure monitoring systems, and the use of ventilators and infusion pumps. Data were collected thorough 200 hours of observation of 60 ICU nurses (100 hours’ pre-intervention and 100 hours’ post-intervention). Response time, type of response, customization of alarm settings for each patient, the person responding to an alarm, and the cause of the alarm were analyzed. Alarms were classified into three types: false, true and technical.
Results. The results showed a statistically significant difference between the pre- and post-intervention frequency of alarm types, frequency of monitoring parameters, customized monitoring settings for patients, and individuals who responded to alarms. The percentage of effective interventions was significantly higher for all parameters after the intervention (46.9%) than before the intervention (38.9%).
Conclusion. The employment of a manual for management of alarms from electronic equipment in ICUs can increase the frequency of appropriate responses to alarms in these units.
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References
Christensen M, Dodds A, Sauer J, Watts N. Alarm setting for the critically ill patient: a descriptive pilot survey of nurses’ perceptions of current practice in an Australian Regional Critical Care Unit. Intensive Crit. Care Nurs. 2014; 30(4):204-10.
Cvach MM, Currie A, Sapirstein A, Doyle PA, Pronovost P. Managing clinical alarms: Using data to drive change. Nursing management. 2013; 44(11):8-12.
Jubic KL. Strategies for Managing Alarm Fatigue in the PICU Setting. Pediatr. Nurs. 2017; 43(5):215-8.
Torabizadeh C, Yousefinya A, Zand F, Rakhshan M, Fararooei M. A nurses’ alarm fatigue questionnaire: development and psychometric properties. J Clin. Monit. Comput. 2017;31(6):1305-12.
Hravnak M, Pellathy T, Chen L, Dubrawski A, Wertz A, Clermont G, et al. A call to alarms: Current state and future directions in the battle against alarm fatigue. J. Electrocardiol. 2018; 51(6): S44-S8.
Baillargeon E. Alarm Fatigue: A Risk Assessment. Rhode Island College; 2013 (cited 14 Apr 2021); Available from: https://digitalcommons.ric.edu/cgi/viewcontent.cgi?article=1218&context=etd
Tanner T. The problem of alarm fatigue. Nurs. Womens Health. 2013; 17(2):153-7.
Flohr L, Beaudry S, Johnson KT, West N, Burns CM, Ansermino JM, et al. Clinician-driven design of vitalpad–an intelligent monitoring and communication device to improve patient safety in the intensive care unit. IEEE J. Transl. Eng. Health Med. 2018; 6:3000114.
Winters BD. Effective approaches to control non-actionable alarms and alarm fatigue. J. Electrocardiol. 2018; 51(6S): S49-S51.
Keller JP. Clinical alarm hazards: a “top ten” health technology safety concern. J. Electrocardiol. 2012; 45(6):588-91.
Bell L. Monitor alarm fatigue. Am. J. Crit. Care. 2010; 19(1):38.
Hannibal GB. Monitor alarms and alarm fatigue. AACN Adv. Crit. Care. 2011; 22(4):418-20.
Cvach MM, Biggs M, Rothwell KJ, Charles-Hudson C. Daily electrode change and effect on cardiac monitor alarms: an evidence-based practice approach. J. Nurs. Care Qual. 2013; 28(3):265-71.
Sendelbach S, Funk M. Alarm Fatigue: A Patient Safety Concern. AACN Adv. Crit. Care. 2013;24(4):378-86.
Cosper P, Zellinger M, Enebo A, Jacques S, Razzano L, Flack MN. Improving clinical alarm management: guidance and strategies. Biomed. Instrument. Technol. 2017; 51(2):109-15.
Graham KC, Cvach M. Monitor alarm fatigue: standardizing use of physiological monitors and decreasing nuisance alarms. Am. J. Crit. Care. 2010; 19(1):28-34.
Welch J. Alarm fatigue hazards: the sirens are calling. JAMA. 2012; 307(15):1591-2.
Waltz CF, Bausell BR. Nursing research: design statistics and computer analysis. Davis FA; 1981.
Inokuchi R, Sato H, Nanjo Y, Echigo M, Tanaka A, Ishii T, et al. The proportion of clinically relevant alarms decreases as patient clinical severity decreases in intensive care units: a pilot study. BMJ Open. 2013; 3(9): e00354.
Taenzer AH, Pyke JB, McGrath SP, Blike GT. Impact of pulse oximetry surveillance on rescue events and intensive care unit transfers: a before-and-after concurrence study. Anesthesiology. 2010;112(2):282-7.
Harris R, Manavizadeh J, McPherson D, Smith L. Do you hear bells? The increasing problem of alarm fatigue. PA nurse. 2011; 66(1):10-3.
Jennings D. User Requirements to Address Fall Monitoring Alarm Fatigue: Capella University; 2019.
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