A Narrative Review on In-Hospital Alarm Fatigue and Telemetry Monitoring Failure: Epidemiology and a Safer Telemetry...

Area of Science:

• Healthcare technology
• Patient safety
• Clinical monitoring

Background:

• Cardiac telemetry is crucial for in-hospital patient safety.
• Systemic failures in processes, policies, and human factors can reduce telemetry effectiveness.
• Alarm fatigue is a major contributor to patient harm in monitored settings.

Purpose of the Study:

• To review factors contributing to hospital monitoring failures.
• To propose the Safer Telemetry Architecture (STA) framework.
• To address complex systemic failures in technological and human factors.

Main Methods:

• Narrative review of sources from multiple databases (PubMed, Scopus, etc.).
• Synthesis of literature on hospital monitoring failures.
• Development of an evidence-based framework (STA).

Main Results:

• Monitoring failures are complex, involving technological and human factors.
• Alarm fatigue significantly impacts patient safety.
• The STA framework identifies redundancies and promotes closed-loop communication.

Conclusions:

• Systemic design flaws in monitored environments cause preventable harm.
• The STA framework improves nurse protocols, alarm routing, backup coverage, and auditing.
• Further validation is needed for the STA framework's effectiveness in improving patient safety.