| Abstrakt: |
Background: Alarm fatigue is a growing concern in the health care arena. It has been reported that 80 - 90% of alarms are considered nonactionable. Alarms add to the noise pollution in the ICU causing desensitization and decreased response rates. The FDA reported 500 alarm-related deaths over a 5-year period. Recently The Joint Commission published the need for alarm management as a Hospital National Patient Safety Goal. The purpose of our study was to determine which alarms trigger most often, whether they are adjustable, and their level of priority. Methods: The 7-day files for alarm history, trends and logbooks were downloaded from 41 Draeger V-500 ventilators. From these files the alarm type, frequency and priority level were determined, as well as the number of hours logged. The ICU that the ventilator was used in was also captured. Data was collected and summarized in Excel and processed using SPSS. Results: Data from 41 ventilators in 7 adult ICUs were collected. A total of 41 different alarms were identified; 8 (20%) of the alarm types were user adjustable, 33 (80%) were not. A total of 7480 alarms were logged; 2221 (30%) were user adjustable, 5259 (70%) were not. For all patients combined, an average of 76 alarms were logged per day (3.1/h); 38 (1.6/h) were high priority, 12 (0.5/h) medium and 26 (1.1 /h) low priority alarms. Almost 60% of the alarms were triggered by 5 alarms: airway pressure high (1193 alarms, 16% of total, adjustable), pressure limited, VT not reached (1193, 16%, not), high PEEP (844, 11.3%, not), leakage (662, 8.9%, not), and VT high (508, 6.8%, adjustable). Limitations: Limitations include a small sample size, use of a single brand of ventilator, not accounting for different ICU's if moved between areas, and inability to assess if the alarm was triggered while the alarm silence was activated during patient care i.e. suctioning, bathing etc. or a patient condition. Conclusions: A majority of alarms that occurred were not able to be set by the bedside clinician. There is a need to find a balance of safe settings and nonactionable alarms, knowing that the majority of alarms are not adjustable. We plan to drill down into the most frequently occurring alarms to determine whether changes in management strategies might help to reduce the incidence of alarm occurrence. A closer examination of alarm management is necessary to identify guidelines that might reduce alarms. Disclosures: We have no conflicts of interest to disclose. [ABSTRACT FROM AUTHOR] |
