Alarm Safety

Alarms are a serious matter in busy hospitals and ERs punctuated 24/7 by the din from cardiac monitors, IV machines, ventilators and other devices. Some alarms are inconsequential. Some are malfunctions. Others signal impending crisis. Many are simply not heard.

The sheer number of devices with alarms – ECG machines, pulse oximetry devices, BP monitors, telemetry, infusion pumps and ventilators, to name a few. According to the Joint Commission, one single patient can set off literally several hundred alarms each day, depending on the severity of their condition and as few as 1 percent of all alarm signals even require clinical intervention. The resulting problem has been given a name by practitioners and researchers: alarm fatigue.
Both technology and behaviors appear to be at the root of the problem. For example, too many varied alarms, both minor and major, simply sound alike.

While most staff recognize the critical role alarms play, they often become desensitized to alarms and overwhelmed by all the noise. They may sometimes set alarm conditions too high, turn alarm volumes down or off, or neglect to adjust alarm default settings for specific patients or populations. In some instances, staff may not hear an alarm because a door may be closed or they may be distracted and might hear the alarms only after a significant amount of precious minutes have lapsed. In other instances, a series of cascading “minor” alarm failures are the culprit. By the time an alarm signals a truly critical event – it might be too late.