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Inpatient-Derived Vital Sign Parameters Implementation: An Initiative to Decrease Alarm Burden

Alaina K Kipps1, Sarah F Poole2, Cheryl Slaney3

  • 1Department of Pediatrics, Stanford Children's Health, Palo Alto, California; akipps@stanford.edu.

Pediatrics
|July 9, 2017
PubMed

Insights

Data-driven vital sign parameters significantly reduced bedside monitor alarms by 21% in a pediatric unit. This quality improvement initiative improved patient safety without missing critical events.

Area of Science:

  • Pediatric critical care
  • Clinical informatics
  • Quality improvement science

Background:

  • Bedside monitor alarms contribute to alarm fatigue.
  • Current vital sign parameters may not be optimized for specific patient populations.
  • Reducing alarm burden is crucial for patient safety and clinical workflow.

Purpose of the Study:

  • To implement data-driven heart rate (HR) and respiratory rate (RR) parameters.
  • To reduce the overall burden of bedside monitor alarms.
  • To assess the safety and impact of new alarm parameters on patient outcomes.

Main Methods:

  • A single-center quality-improvement initiative using historical controls.
  • Implementation of age-based, inpatient-derived HR and RR parameters on a pediatric acute care ward.
  • Primary outcome: reduction in alarms per monitored bed day (MBD).

Main Results:

  • Median alarms per MBD decreased by 21% (52 to 41, P < .001).
  • Significant reductions observed in HR alarms (17%) and RR alarms (53%).
  • No increase in missed rapid response team activations or critical events.

Conclusions:

  • Data-driven HR and RR parameters effectively decreased total alarm frequency by 21%.
  • The implemented changes were safe and did not compromise patient monitoring.
  • Optimized vital sign parameters can reduce alarm burden in pediatric acute care settings.
Abstract

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