Professional Documents
Culture Documents
Alarm Fatigue
Siera R Stokes
Many families and caregivers are unaware of the fact that countless hospital
personnel become fatigued and desensitized to the beeping of monitors and alarm
systems examining patients during their stay. Alarm fatigue is an incredibly serious
problem that consists of health care team members either silencing, ignoring, or simply
not processing the cacophony of alarms going off throughout each day and night.
Employees are not trying to be ignorant towards the noise, there are simply just so many
alarms heard each day that their response becomes dulled to each beep. The States News
Alarm fatigue occurs when nurses and other clinicians are exposed to a high
turn, alarms are ignored and critical alarms are missed because many alarms
This phenomenon has been an evolving issue, and is currently taking place in hospitals
throughout the world. The States News Service (2014) also stated that
and her colleagues at the University of California San Francisco, revealed more
than 2.5 million alarms were triggered on bedside monitors in a single month.
With this many alarms beeping, it is understandable how one can become immune to the
significance is that with different alarms being ignored or silenced throughout the day
patients may not be receiving adequate care, or there may possibly be critical situations
that could have been avoided if the alarms had been tended to earlier. Majority of the
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potential problems and these alarms need to be heard and acted on. Alarm fatigue can
taught that
Depending on the hospital unit type, several hundred alarms per patient may
or ignoring alarms, which increases the likelihood that a true critical patient
alarm is missed. This phenomenon is called alarm fatigue, and at its worst, a
missed critical true alarm can lead to patient injury and death
As for now, many alarms are silenced numerous times without any interventions.
Parameters are usually set by specialists, which may require further adjusting to minimize
the amount of alarms being set off, however the specialists are not in the patient’s room
frequently so the parameters may stay set at specific boundaries for prolonged amounts of
time. Alarm fatigue impacts patients in numerous ways including: beeping, which tends
to keep interrupt sleep, irritation to family members, increased risk for missing critical
alarms, and reduces the known severity of a situation if an actual problem occurs.
Currently, the main practice when responding to alarms is to react to the alarm
and handle the situation appropriately or to “silence” the alarm if there is an important
matter and respond to it when the nurse has a chance to. The only help offered is from
monitor watchers. While explaining what this means, Funk (2016) stated
nurses. When monitor watchers are nurses, they may be tasked with watching
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may be located on the unit being monitored, in a different unit in the hospital, or
Monitor watchers are not utilized in every hospital, however their presence is increasing.
Center to see if monitor watchers improve the care provided and decreased the amount of
alarms that were ignored or silenced, and concluded with mixed opinions (Cardiovascular
Week, 2014). Along with monitor watchers, the other possibility for decreasing alarm
fatigue is to personalize the parameters set on the monitors for each patient and to change
them as needed if the patient’s health is improving or declining. According to the clinical
study these two implementations are currently supported and proven to decrease alarm
fatigue. By personalizing the parameters for each patient, it would lessen the amount of
unnecessary alarms sounded each day and would thus help nurses realize the importance
of the alarms that are set off. Cardiovascular Week published a statement about
personalized parameters explaining, “The process reduced the median number of daily
cardiac alarms from 180 to 40, and increased caregiver compliance with the process from
ranging from stating that monitor watchers were extremely helpful while some shared
that they were not helpful. One participant indicated, "I have had to educate [the monitor
watchers] many times that the rhythm they identify [is] NOT fatal or dangerous (i.e.,
noise). I receive about 10 calls during a typical shift. They do receive a basic rhythm
class, but so many times they call over false rhythms." Another participant said, "I think
monitor watchers ... provide a false sense of security. I've taken care of multiple patients
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in our cardiac ICU after arrests where resuscitation was delayed because no one was
paying attention." On the other hand, there were positive responses such as, "I like the
system of having a person whose job it is to watch the monitors. As a staff RN, I am
much too busy to be checking the monitor as frequently as I think it should be checked."
After reviewing this article, it is apparent that both of these interventions have the
potential to be useful, but need some improvement. Adjusting parameters would require a
specialist to visit the patient regularly to see if the current settings are appropriate and
would need to be changed when necessary. If all hospitals were to use monitor watchers,
it may be necessary for them to receive more instruction and education on which beeps
are vital and which are not. Furthering education would be especially important on floors
provide the opportunity to allow nursing students, but not on all of the units. Students
have witnessed monitor watchers who alert nurses through Vocera if there is a change on
patient’s ECG readings and that was the extent of it. Students have also seen specialists
change the parameters for patient’s monitors on a few ICU floors, however majority of
their patients have not received this individual care. After seeing these interventions try to
be executed it is apparent that there are some barriers preventing complete adherence.
First, the monitor watchers need to be taught what to watch for in cardiac strips and also
for ranges in vital signs that are acceptable. Second, there needs to be clear and quick
communication between monitor watchers and nurses if there is a serious problem. As for
changing parameters on monitors, it isn’t completely feasible for specialists to change the
parameters when a nurse decides it is appropriate, but may be possible if the physician
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allows time each day to do an assessment and then decide if the settings need to be
changed. There also needs to be some sort of indicator as to when the parameters should
be changed for each patient or a policy set in place as to keep things organized and
attempted before finding a resolution for alarm fatigue. More research should be done on
the topic to see what interventions have helped or not helped as well. Alarm fatigue is
members working together there may be a viable solution to the problem that continues to
worsen.
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References
Funk, M., Ruppel, H., Blake, N., & Phillips, J. (2016). Use of monitor watchers in hospitals:
Jahrsdoerfer, M. (2016). Case Study: Reducing Interruption Fatigue through Improved Alarm
McKinney, M. (2013). Lives at risk. Hospitals face hurdles addressing alarm fatigue. Modern