Cause for Alarm: Reducing the Adverse Consequences of Alarm Fatigue
In health institutions, alarms from physiologic monitors play a crucial role in protecting patient safety and facilitating care. However, excessive false alarms arising from preventable situations such as poor signal detection and over-monitoring of patients may reduce a healthcare worker’s ability to identify and prioritize these signals. Termed “alarm fatigue”, this mental phenomenon can decrease workplace productivity, leading to adverse outcomes for patients when alarms are silenced to be addressed later, or when alarms becomes a technological barrier to direct, meaningful patient care. Alarms also contribute greatly to the ambient noise within hospital wards, which, in excess, can negatively impact patients’ mental wellbeing and recovery. Listed as one of the top healthcare problems in recent years, alarm fatigue has been studied extensively in literature, and quality improvement protocols have been implemented in many institutions to combat this phenomenon. Recommendations include reserving the use of physiologic monitors for patients who are clinically indicated for them, replacing single-use adhesive sensors more frequently to improve detection, individualizing vital parameters for each patient, delaying alarms for transient signals that can resolve spontaneously on their own, enhancing the ergonomics of alarm design from an engineering standpoint, and establishing an interdisciplinary approach to managing alarm systems. Studies reveal positive results from these interventions, where dropped rates of false alarms mean enhanced delivery of purposeful healthcare and increased workplace satisfaction. However, more research will be needed to evaluate the limit to which we can cut back on alarms without compromising patient safety.