Mitigating Alarm Fatigue and Improving the Bedside Experience by Reducing Nonactionable Alarms

Area of Science:

• Critical Care Medicine
• Biomedical Engineering
• Patient Safety

Background:

• Alarms from bedside monitors are crucial for patient safety but often lead to alarm fatigue due to high frequency of nonactionable alerts.
• Reducing nonactionable alarms is essential to improve the effectiveness of clinical alarm systems and prevent adverse events.

Purpose of the Study:

• To evaluate the impact of conditional bedside alarm triggers on the frequency of nonactionable alarms.
• To assess whether these changes affect patient safety and satisfaction among nurses and families.

Main Methods:

• A single-center quality improvement initiative was conducted in an acute care cardiac unit and a pediatric intensive care unit.
• Bedside monitors were reprogrammed with hierarchical time delay and conditional alarm triggers after a baseline period.
• Alarm data and patient safety events were collected, and nurses and families were surveyed pre- and post-intervention.

Main Results:

• A significant reduction in median alarms per monitored patient day was observed: 75% in the pediatric intensive care unit and 82% in the acute care cardiac unit.
• Alarm reduction was sustained at a 2-year follow-up, with no increase in rapid response calls, emergent transfers, or code events.
• Nurses reported improved capacity to respond to alarms and fewer perceived nonactionable alarms; however, family surveys did not show improved sleep quality.

Conclusions:

• Modifications to bedside monitor alarm systems using conditional triggers effectively decreased total alarm frequency in critical care settings.
• These changes improved the care provider experience and maintained patient safety.
• Further research may be needed to address family satisfaction regarding sleep quality.