Reducing redundant alarms in the pediatric ICU

Abstract

Physiologic monitors generate alarms to alert clinicians to signs of instability. However, these monitors also create alarm fatigue that places patients at risk. Redundant alarms have contributed to alarm fatigue without improving patient safety. In this study, our specific aim was to decrease the median percentage of redundant alarms by 50% within 6 months using the Model for Improvement. Our primary outcome was to lower the percentage of redundant alarms. We used the overall alarm rate per patient per day and code blue events as balancing metrics. We completed three Plan-Do-Study-Act cycles and generated run charts using standard industry criteria to determine the special cause. Ultimately, we decreased redundant alarms from a baseline of 6.4% of all alarms to 1.8%, surpassing our aim of a 50% reduction. Our overall alarm rate, one of our balancing metrics, decreased from 137 alarms/patient day to 118 alarms/patient day during the intervention period. No code blue events were determined to be related to incorrect setting of alarms. Decreasing redundant alarms is safe and feasible. Following a reduction in redundant alarms, more intensive alarm reduction methods are needed to continue to reduce alarm fatigue while keeping patients safe.