Boston Medical Center (BMC) tested a novel approach to addressing alarm fatigue on its telemetry unit and successfully reduced audible alarms and improved patient safety across six weeks, leading the hospital to implement the strategy on all inpatient medical/surgical units.

Alarm fatigue occurs when clinicians become desensitized to the incessant beeps from monitors, which may lead to slower response times.

Strategy

Problem: Life-threatening arrhythmic events were only preceded by warning alarms.

Solution:

  • BMC raised warning alarms to crisis alarms, which are heard in real time and require immediate action.
  • Nurses tailored alarm settings based on individual patient needs so only true crises were indicated as such.
  • Clinical engineering staff synchronized heart rate default values at the central monitoring station and on bedside monitors and communicated daily changes to nursing staff.
  • Admitting clinicians used only the pilot roll out orders for new admissions to the unit.

Results

The strategy helped BMC reduce audible cardiac monitor and telemetry alarms by 89 percent and daily audible alarm averages from 12,546 to 1,424 on the cardiology unit. Meanwhile, noise levels dropped from 90 decibels pre-pilot to 72 decibels.

Daily reviews of incident reports also showed that no adverse events involving cardiac monitoring were reported during the pilot. Results of the pilot were published online in the Journal of Cardiovascular Nursing.

The changes – which didn’t require additional technology or financial resources – also allowed staff to spend more time on direct patient care instead of responding to meaningless alarms. According to scores recorded through Press Ganey Inpatient Metrics, nurse responsiveness increased and patients’ needs were addressed more promptly, when comparing the seven months before the pilot and the seven months after the pilot.

“While some hospitals are looking to add technology to combat this issue, BMC’s approach demonstrates the opportunity for clinicians to interact with current alarm systems more effectively to decrease clinical alarm fatigue while simultaneously capturing and displaying all important alarms.” James Piepenbrink, director of clinical engineering at BMC and study coauthor

Based on the pilot’s success, BMC rolled out the strategy on all inpatient medical/surgical units, and by January 2013, 310 of 332 beds on these units were operating under the new alarm standards and seeing significant alarm reductions.

For more information on BMC’s alarm fatigue program, please contact:

Jenny Eriksen Leary
Senior Public Relations Associate
Office of Communications
Boston Medical Center
617.638.6841
jenny.eriksen@bmc.org