Variations in Alarm Burden, Source, and Cause Across Inpatient Units at a Children's Hospital

Area of Science:

• Biomedical Engineering
• Patient Safety
• Clinical Informatics

Background:

• Clinical alarms are essential but frequently generate high volumes, contributing to alarm fatigue.
• Alarm fatigue poses significant risks to patient safety in hospital settings.
• Understanding alarm burden is crucial for developing effective mitigation strategies.

Purpose of the Study:

• To quantify the alarm burden over a one-year period in a children's hospital.
• To analyze variations in alarm rates based on unit type, alarm source, and specific causes.
• To identify key drivers of alarm frequency for targeted interventions.

Main Methods:

• Retrospective analysis of inpatient alarm and patient census data from January 1, 2019, to December 31, 2019.
• Inclusion of data from six medical/surgical units (MSU), one pediatric intensive care unit (PICU), and one neonatal intensive care unit (NICU).
• Calculation of alarm rates per patient day (appd) and utilization of Poisson regression for comparative analysis.

Main Results:

• A total of 7,934,997 alarms were recorded over 84,077 patient days, averaging 94.4 appd.
• Alarm rates varied significantly by unit type (NICU: 117.5 appd, PICU: 90.7 appd, MSU: 81.3 appd).
• Pulse oximetry (POx) probes were the most frequent alarm source, with "low oxygen saturation" being the leading cause, particularly in NICU and PICU settings.

Conclusions:

• Clinical alarm frequency and characteristics differ substantially across hospital units, sources, and causes.
• Strategies to reduce alarm burden should consider unit-specific alarm rates and prevalent alarm sources like POx.
• Targeted interventions are necessary to mitigate alarm fatigue and enhance patient safety.