The Wrong Kind of Monitoring in Hospitals?

By Jane Farrell

Millions of physiological alarms in hospitals are triggered each month, and the technology needs to be improved to avoid further “alarm fatigue” among health care providers, according to a new study.

Researchers from the University of North Carolina, Chapel Hill, and the University of California said their study of alarm fatigue was the first ever reported from a real-world hospital setting.

Alarm fatigue occurs when nurses and other clinicians are exposed to a high number of physiological alarms from monitoring systems. Because many alarms are false, they can be ignored, and critical alarms can be missed.

Alarm fatigue has become a growing issue of patient safety.

“Current technologies have been instrumental in saving lives but they can be improved,” said Jessica Zègre-Hemsey, who is an assistant professor at the UNC-Chapel Hill School of Nursing. “For example, current monitoring systems do not take into account differences among patients. If alarm settings were tailored more specifically to individuals that could go a long way in reducing the number of alarms health care providers respond to.”

The investigators looked at statistics on alarms involving 461 adults in five intensive care units at the University of California San Francisco Medical Center over a period of 31 days. They found that 88.8 of the 12,671 arrhythmia alarms, designed to alert providers to abnormal cardiac conditions, were false. Most of the false alarms were caused by technical malfunctions or brief spikes in heart rate.

Zègre-Hemsey said that reducing alarm fatigue will require close collaboration between clinicians, hospital administrators and engineers – as well as additional research.

The study was published in the journal PLOS One.