Physiologic Monitor Alarm Rates at 5 Children's Hospitals

Area of Science:

• Clinical Informatics
• Patient Safety
• Healthcare Quality Improvement

Background:

• Alarm fatigue, caused by excessive and often non-actionable monitor alarms, is a critical patient safety concern.
• It can lead to delayed or missed responses to critical events, increasing patient morbidity and mortality.
• Understanding current alarm burden is essential for developing effective mitigation strategies.

Purpose of the Study:

• To quantify alarm rates and types across different units in freestanding children's hospitals.
• To identify patient populations contributing disproportionately to the overall alarm burden.
• To provide data for targeted interventions to reduce alarm fatigue.

Main Methods:

• A point-prevalence, cross-sectional study design was employed.
• Audible alarms were collected from all inpatient units at 5 freestanding children's hospitals over a single day.
• Alarm rates were calculated per monitored patient per day, categorized by alarm type.

Main Results:

• A total of 147,213 alarms were recorded during the study period.
• Significant variation (3-fold) in alarm rates was observed across hospitals for similar unit types.
• A small proportion of monitored beds (approximately 25%) accounted for a large majority of alarms (71% in medical-surgical, 61% in NICU, 63% in PICU).

Conclusions:

• High alarm burden and significant inter-hospital variability exist in children's hospitals.
• A concentrated group of patients generates a disproportionate number of alarms, suggesting a target for intervention.
• Focusing on reducing non-actionable alarms in high-alarm-count patients may effectively decrease overall alarm rates and mitigate alarm fatigue.