Year of Publication

2018

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Carol Thompson

Clinical Mentor

Dr. Lacey Buckler

Committee Member

Dr. Nora Warshawsky

Abstract

PURPOSE: To obtain insight into the nursing culture of the University of Kentucky Medical Center (UKMC) regarding alarm fatigue, measure nuisance alarm events, and identify the practices nurses at UKMC engage in to manage alarm pollution and mitigate alarm burden. Moreover, this practice improvement project identified how innovations like the introduction of a monitor watcher has impacted the rates of nuisance alarms and influenced nursing culture.

METHODS: A online survey based on the 2011 Healthcare Technology Foundation Alarms Survey (HTF) was sent to nurses in two intensive care units at UK Healthcare (UKHC). The results of the 2017 UKHC Alarm Survey were compared to published studies that used a similar version of the 2011 HTF Alarms Survey. Also, alarm events were recorded and categorized based on frequency and type to assess the number of nuisance alarms present in each unit.

RESULTS: Survey results found in published studies were like those found at UK Healthcare with an exception noted that UKHC nurses reported lower agreement scores when asked about the helpfulness of a monitor watcher. Repetitive and clinically irrelevant alarms (ECG nuisance alarms) made up about a third of all alarm events recorded at UKHC and these numbers were unaffected by the attendance of a monitor watcher. Also gaps in nursing education related to alarm management issues were identified.

CONCLUSION: Interventions such as the routine deactivation of repetitive and clinically irrelevant alarms may result in a lessening of the factors that contribute to the development of alarm fatigue. Hospital polices must be updated to encourage customization of alarms with special attention being given to efforts that reduce nuisance alarms. Education gaps can be addressed by a standardized approach to the education of all nurses who work with clinical monitors.

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