02/12/2025
Constant alarms can be very triggering and heighten stress, so usually the solution is to silence them or alter the settings. But how detrimental can this be to the care we are giving to our patients; can it cause things to be missed?
Clinical alarms in medical devices play a vital role in enhancing patient safety by alerting healthcare professionals of any physiological changes that may require immediate intervention (Mindray). The alarms act as an early warning system to prevent patient deterioration and adverse outcomes. However, the increasing sensitivity of alarm systems has led to an overwhelming number of false or non-actionable alerts, resulting in a phenomenon known as alarm fatigue (Cvach, 2012). This issue has proven detrimental to patients; in human medicine, between 2005 and 2010, 216 deaths across the United States were linked to unheard or dysfunctional alarms, and between 49% and 96% of clinical alarms were overridden (Mindray).
The consistent alarms have also resulted in cognitive overload, where repeated exposure to uninformative alerts results in reduced responsiveness to important warnings (Ancker et al., 2017). Think of “a boy who cried wolf”. A hypothesis arising from two possible alarm fatigues was tested: a) cognitive overload associated with amount of work, complexity of work, and effort distinguishing informative from uninformative alerts, and b) desensitisation from repeated exposure to the same alert over time (Ancker et al., 2017). The findings supported a model of alarm fatigue, which arises from the difficulty in distinguishing relevant alerts from irrelevant ones due to the high number of informative alerts (Ancker et al., 2017).
Therefore, should we consider altering the settings to only alert for what’s relevant for our patients?
To reduce alarm fatigue, RVNs should have more awareness of the safety behind alarms; therefore, the appropriate training should be available to give us the ability to safely optimise alarm levels and frequencies (Shaoru et al., 2023). Cvach (2012) also concludes that training RVNs to be able to safely adjust alarms to patients’ actual needs ensures that the alarms are valid and provides an early warning to potential critical situations. It’s also been seen to be effective to document alarm parameters, improving alarm adjustment compliance, e.g., in a cat, setting the heart rate alarm settings to 100-200 bpm.
Let's get Lit:
- https://tinyurl.com/mindraycrozfusion
- https://journals.sagepub.com/doi/full/10.1177/23779608231207227
- https://array.aami.org/doi/10.2345/0899-8205-46.4.268
- https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-017-0430-8
