Stop the Noise: A Quality Improvement Project to Decrease Electrocardiographic Nuisance Alarms
Sue Sendelbach1, Sharon Wahl2, Anita Anthony2
1Sue Sendelbach is director of nursing research at Abbott Northwestern Hospital, Minneapolis, Minnesota, and is on the Association of the Advancement of Medical Instrumentation's committee on alarm management/alarm fatigue.Sharon Wahl is a cardiovascular clinical nurse specialist at Abbott Northwestern Hospital and has facilitated several projects on alarm management within the critical care patient care units.Anita Anthony is a clinical nurse specialist and at the time of the project worked in the progressive care unit at Abbott Northwestern Hospital. She is now at University of Minnesota Medical Center in Minneapolis.Pamela Shotts is a quality specialist and manages the data for the alarm management project at Abbott Northwestern Hospital. sue.sendelbach@allina.com.
Background:
As many as 99% of alarm signals may not need any intervention and can result in patients' deaths. Alarm management is now a Joint Commission National Patient Safety Goal.
Objectives:
To reduce the number of nuisance electrocardiographic alarm signals in adult patients on the medical cardiovascular care unit.
Methods:
A quality improvement process was used that included eliminating duplicative alarms, customizing alarms, changing electrocardiography electrodes daily, standardizing skin preparation, and using disposable electrocardiography leads.
Results:
In the cardiovascular care unit, the mean number of electrocardiographic alarm signals per day decreased from 28.5 (baseline) to 3.29, an 88.5% reduction.
Conclusion:
Use of a bundled approach to managing alarm signals decreased the mean number of alarm signals in a cardiovascular care unit.
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