Addressing vital sign alarm fatigue using personalized alarm thresholds

Area of Science:

• Biomedical Engineering
• Clinical Informatics
• Pediatric Critical Care

Background:

• Alarm fatigue, caused by frequent, non-actionable alarms, is a critical patient safety issue.
• Current pediatric vital sign alarm thresholds are often inappropriate, leading to excessive alarm burdens.
• The variability of pediatric vital signs necessitates tailored alarm management strategies.

Purpose of the Study:

• To develop and evaluate personalized vital sign alarm thresholds for pediatric patients.
• To reduce the incidence of unnecessary low and high heart rate alarms.
• To improve patient safety and clinical workflow efficiency by mitigating alarm fatigue.

Main Methods:

• Utilized a large dataset of over 190 patient-years of pediatric heart rate data.
• Identified individual 1st and 99th percentile heart rate values from the first day of monitoring.
• Compared personalized thresholds against standard non-default thresholds and clinical events for validation.

Main Results:

• Personalized thresholds reduced low heart rate alarms by up to 50% and high heart rate alarms by up to 44%.
• Maintained a sensitivity of 62% for detecting critical events.
• Increased specificity to 49%, indicating fewer false alarms.

Conclusions:

• Personalized vital sign alarm thresholds effectively reduce alarm fatigue in pediatric settings.
• Implementation can lead to improved patient outcomes, reduced hospital stays, and lower healthcare costs.
• This data-driven approach offers a promising strategy for optimizing alarm management in pediatric care.