Algorithm reduces « alarm fatigue » - L'Infirmière Magazine n° 337 du 15/01/2014 | Espace Infirmier
 

L'infirmière Magazine n° 337 du 15/01/2014

 

FORMATION CONTINUE

FORMATION ANGLAIS

Medical device alarms may pose a threat to patient safety when they generate alarms that are either false or clinically insignificant, resulting in nurses’ desensitization or « alarm fatigue ». Staff may fail to respond to a true emergency.

Innovations to reduce false alarms include using « smart alarms », which apply multiparameter filters ; employing expensive human monitor-watchers ; and using pagers, which may have connectivity issues and lack necessary filters. At a new two-ward cardiac unit at Johns-Hopkins Hospital, Baltimore, USA, nurses trialled a new system which had the two aims of decreasing « the average frequency and duration of high-priority cardiac monitor alarms per monitored bed » and improving « nurses attitudes about clinical alarms, including their perception of effectiveness of notification devices ».

An alarm escalation algorithm was developed after analysing alarm logs. It determined which cardiac monitor alarms were actionable, prioritized them and sent them to a nurse’s radio-based pager. The nurse then closed the communication loop by acknowledging receipt of the page. Results indicate that the algorithm and acknowledgement pager improved nurse notification of high-priority alarms and reduced alarm fatigue. Best results were noted in the ward where each nurse carried a pager, as opposed to the ward where only the charge nurse carried a pager.

From Journal of Nursing Care Quality : January/March 2014 – Volume 29 – Issue 1 – p 9-18 doi : 10.1097/NCQ.0b013e3182a61887

Voir aussi : www.hopkinsmedicine.org/news/using_data_to_drive_alarm_improvements.html

MOTS ET EXPRESSIONS

Device (n) Dispositif ; appareil

Alarm (n) Alarme (le dispositif ou le signal qu’il émet)

Desensitization (n)

Insensibilité

Pager/page (n)

Bipeur/ le message qu’il émet

Escalation (n)

Intensification

Logs (n pl)

Journaux de bord ; registres de données

To acknowledge receipt (v)

Accuser réception

Charge nurse (n)

Infirmière en chef

QUESTIONS

1. Why are human monitor-watchers not a popular strategy for reducing false alarms ?

They cost too much money.

2. In the Johns-Hopkins study, how are pager connectivity issues avoided ?

The pagers are connected using radio frequencies.

3. What actions does a nurse take when she receives an alarm page ?

She acknowledges receipt of the page, and treats the patient appropriately.