How to Reduce Alarm Fatigue: 5 Tips for Facilities

If you’ve ever stepped inside of a hospital unit, you know that the environment can get quite noisy and chaotic. Dinging and beeping noises can be heard from every direction, making you feel like you walked straight into an amusement park. For the nurses working in your facility, however, alarm fatigue can be a real barrier to providing safe patient care.

What is alarm fatigue? Follow along as we describe the concept and provide ways for your facility to cut out unintentional monitor and device noises to improve the quality of care for your patients.

Alarm Fatigue: Frequently Asked Questions

Before we share tips for improving your clinical alert systems, it’s important to understand what alert fatigue is and the impact it can have on your staff and patients. As an overview, here are answers to some of the most frequently asked questions about this phenomenon.

What is alarm fatigue in nursing?

The AACN describes this as the sensory overload that occurs when nurses are exposed to a high number of alarm alerts. These sounds can emit from such devices as:

• Vital sign monitors
• Infusion pumps
• Respiratory ventilators
• Patient call bells
• Dialysis machines

When prolonged, this can lead to alarm desensitization. As a result, staff may start to ignore alarms, have delayed reactions, or fail to respond appropriately to warnings.

How does alert fatigue affect nurses?

When nurses are overexposed to alarms, it becomes harder to prioritize tasks. Noises that were designed to help nurses quickly respond to emergency concerns or machine malfunctions now clutter hospital units, making it difficult for nurses to focus. Over time, this overexposure contributes to burnout.

One study found that a single hospital unit produced nearly 17,000 alarm sounds over an 18-day period, averaging around 950 alarms per day. Over 72% of all alarms produced in these units are false alarms. Nurses grow to expect that a beep or a buzz is a needless alert, and sounds are often ignored for other tasks that seem more crucial.

What is the greatest risk of alarm fatigue?

In the event of a real emergency, alarm response may be delayed, resulting in a critical event or even patient death before the nurse has time to attend to the alert. If a patient’s heart rhythm monitor is constantly emitting false alarms, staff may be less likely to respond when an abnormal vital sign or fatal arrhythmia actually develops.

Patient satisfaction is also affected by unnecessary alarms. Noises and alerts prevent patients from sleeping at night, increasing the risk of ICU delirium and psychosis.

What are alert fatigue symptoms?

Recognizing common signs of alert fatigue can enable you to intervene more quickly and make necessary improvements to your unit. These signs may include:

• Delayed response times: Staff who are desensitized to alarms may respond to warnings and call lights with less urgency.

• Decreased productivity: Multiple false alarms and noises can make it difficult for staff to focus and prioritize care tasks, which can decrease their overall productivity.

• Increased stress and burnout: Hearing too many hospital alarm sounds can increase stress for both patients and staff. This can become quite overwhelming, also contributing to nurse burnout.

5 Ways to Reduce Alarm Frequency

Improving clinical alert systems is a priority of healthcare administrators and is a national patient safety goal of The Joint Commission. Alarm fatigue solutions should be implemented by facilities looking to receive hospital safety accreditation. We’ve provided five innovative ideas to help your team get started.

1. Proper Skin Preparation Protocol

Waveform artifacts, which are false cardiac readings on a patient monitor, can be caused by improper lead placement or poor adhesive connection with the patient’s skin. Studies show decreased false alarms in hospital units that regulate bathing and electrocardiogram (ECG) electrode replacement. Washing the patient’s chest with soap and water and changing ECG electrodes daily can significantly reduce the number of inappropriate alerts from the patient’s vital signs monitor.

Facility administrators can help reduce unnecessary nursing alarms by initiating a bathing and electrode replacement protocol. Standardizing the timing and frequency of daily bathing can help nurses ensure that telemetry readings are correct and inaccurate arrhythmia alarms are minimized.

2. Customization of Alarm Parameters

Patient monitors are often initiated with standard vital sign parameters and provide a very general baseline for monitoring health status. Hospitals can limit the number of inappropriate warning noises by tailoring each individual’s monitor parameters to their health status.

For example, standard low oxygenation (SpO2) parameters might be set for 88%, but a patient with COPD has a baseline SpO2 of 84%. Without personalizing the patient’s monitor, it would constantly ding with a low warning while the patient was comfortably resting in bed. A simple change in alarm parameters from 88% to 80% would significantly reduce the number of alerts that emit from the device.

Limiting false alarms helps staff recognize when a vital sign or test result is clinically significant. Healthcare administrators can help their team develop electronic health record (EHR) order sets to regulate new, customized alarm parameters for patients on telemetry monitoring.

3. Direct Staff Phone Alerts

Loud, overhead alarms should be a thing of the past. With the expansion of communication technology, most hospital staff use cellular phones or pagers. Monitor technology can link with these personal devices to send alerts to individual nurses responsible for each patient.

Limiting the number of noises that each member of staff is exposed to keeps the overall noise to a minimum. Additionally, patients are able to sleep better at night and feel more at ease because the alert sound goes to the nurse’s phone, not from the monitor in the patient room.

4. Timely Discontinuation of Monitor Use

Many facilities continue telemetry monitoring of patients long after it’s necessary. By developing a protocol to assist nurses in turning off cardiac monitoring, hospitals can decrease the amount of non-actionable vital sign alarms by 99%.

5. Staff and Patient Education

No intervention can be effective without staff education and buy-in. Helping clinicians to understand the importance of limiting unnecessary alarms is the first step in making units safer and quieter for patients.

Studies show a 43% decrease in alarm frequency after providing nurses education and resources for better clinical alert management. Involving other members of the team (like medical assistants, respiratory therapists, and doctors) can help limit sensory overload facility-wide.

Educational programs surrounding alarm systems are important for patients as well. It can be frightening for patients to hear all of these noises during a time they’re supposed to be resting and recovering.

Patients should be taught about the need for alarms, what the different noises may mean, and be informed of the ways the medical team plans to address these alarms during their stay. Encouraging patients to be involved in their plan of care helps improve outcomes and boosts patient satisfaction scores.

Discover More Ways to Improve Patient Safety

Focusing on reducing alarm fatigue is one of the many ways healthcare facilities can enhance patient safety and reduce healthcare professionals’; stress. Want to learn more? Don’t miss out; IntelyCare’s free newsletter provides even more ways to improve patient safety and wellbeing.