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Whats that noise? Bedside monitoring in the Emergency Department
Rob B Way1, Sally A Beer1, Sarah J Wilson2
1Emergency Department, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, United Kingdom.
Objective:
To determine the frequency, duration and type of audible monitor alarms in an ED, utilising the standard manufacturer's classification.
Methods:
The audible monitor alarms and the timing of any intervention related to the patient monitoring was observed and recorded.
Results:
110 Patients admitted to the Majors area or Resuscitation Room were observed for a total of 93 hours. One monitor was observed at a time. Alarm noise was generated 29% of the observation time. Overall, 429 alarms lasting 21 hours 27 minutes were judged to be positive and 143 alarms lasting 5 hours 47 minutes, negative. 74% of Resuscitation Room and 47% of Majors alarms were silenced or paused. Alarm limit parameters were only adjusted after 5% of alarms in Resuscitation Room and 6% of alarms in Majors.
Conclusions:
Whilst high level monitoring is desired from a patient safety perspective, it contributes to a significant ambient noise level, which is recognised by all who pass through an ED, and can be detrimental to patients, relatives and staff. We have demonstrated that there is a high probability of near-continuous alarm noise from patient monitoring in a 10-bedded Majors area. We make suggestions for methods of noise reduction and intend to implement some of these within our own ED.
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