Reducing Nuisance Telemetry Alarms in the Adult Inpatient Setting

Background: Excessive generation of clinical alarms can result in ignored alarms and staff alarm fatigue putting patient safety at risk. A retrospective chart review reported an average of 19.44 alarms/patient/hour were generated on two 26-bed acute care units. Evidence supported implementing an alarm bundle. Objectives: This quality improvement project aimed to implement an evidence-based bundle to reduce the number of nonactionable telemetry alarms occurring on two adult acute care inpatient units in a large community hospital. Methods: Weekly audits were used to assess workflow adherence. Run charts were used to show process adherence from audit findings. Results: Adherence to daily electrode sticker changes was 80% (n = 118) and 75% (n = 110) for electronic medical record (EMR) documentation. Error with Lead V sticker placement occurred at 34% (n = 50) frequency. Once, a shift parameter documentation was 75% (n = 194) and 86% (n = 117) for customized parameter documentation. Frequency of nurse-driven heart rate parameter customization was 17% (n = 44). Adherence to the use of standby was 75% (n = 166). Conclusions: Safe clinical judgment was used in customizing parameters for patients experiencing heart rate significantly above or below parameter threshold. Implications for Nursing: An evidence-based alarm bundle can be introduced safely and reduces nonactionable alarms in the adult acute care setting.