Association between exposure to nonactionable physiologic monitor alarms and response time in a children's hospital
| Autor: | A. Russell Localio, Ron Keren, Richard Lin, Christine Weirich Paine, Whitney Rock, Margaret Fortino, Christopher P. Bonafide, Miriam Zander, Vinay M. Nadkarni, Andrew Rich, Kathryn E. Roberts, Christian Sarkis Graham |
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| Rok vydání: | 2015 |
| Předmět: |
Mechanical ventilation
Pediatric intensive care unit medicine.medical_specialty Multivariate analysis Leadership and Management business.industry Health Policy medicine.medical_treatment Workload General Medicine Assessment and Diagnosis 3. Good health Hospital medicine 03 medical and health sciences ALARM Patient safety 0302 clinical medicine 030225 pediatrics medicine Fundamentals and skills Observational study 030212 general & internal medicine Intensive care medicine business Care Planning |
| Zdroj: | Journal of Hospital Medicine. 10:345-351 |
| ISSN: | 1553-5592 |
| DOI: | 10.1002/jhm.2331 |
| Popis: | BACKGROUND Alarm fatigue is reported to be a major threat to patient safety, yet little empirical data support its existence in the hospital. OBJECTIVE To determine if nurses exposed to high rates of nonactionable physiologic monitor alarms respond more slowly to subsequent alarms that could represent life-threatening conditions. DESIGN Observational study using video. SETTING Freestanding children's hospital. PATIENTS Pediatric intensive care unit (PICU) patients requiring inotropic support and/or mechanical ventilation, and medical ward patients. INTERVENTION None. MEASUREMENTS Actionable alarms were defined as correctly identifying physiologic status and warranting clinical intervention or consultation. We measured response time to alarms occurring while there were no clinicians in the patient's room. We evaluated the association between the number of nonactionable alarms the patient had in the preceding 120 minutes (categorized as 0–29, 30–79, or 80+ alarms) and response time to subsequent alarms in the same patient using a log-rank test that accounts for within-nurse clustering. RESULTS We observed 36 nurses for 210 hours with 5070 alarms; 87.1% of PICU and 99.0% of ward clinical alarms were nonactionable. Kaplan-Meier plots showed incremental increases in response time as the number of nonactionable alarms in the preceding 120 minutes increased (log-rank test stratified by nurse P |
| Databáze: | OpenAIRE |
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