Alarm management: A systems approach to patient safety

Abstract

The purpose of a medical device alarm is to command the attention of the clinician for notification of an immediate or potential adverse patient condition. It should be actionable and requires a response. The frequency of false alarms has increased due to increased numbers of alarming devices, lack of standardization of alarms, and alarm settings with sensitivity over specificity. In some hospitals alarm signals can reach several hundred per patient, with most requiring no clinical intervention. Clinicians can become overwhelmed and desensitized by the frequency of these alarms. During the last six years, there have been patient deaths reported that were attributed to “alarm fatigue.” Clinical alarm hazards have been cited as being among the top ten health technology hazards for several years. As a result, a national initiative is underway in the United States focusing on safe use of alarms. Appropriate use of well-designed devices and an organized work environment can reduce risks and increase safety. Alarm customization, tailoring alarm parameters to individual patient needs, communication between clinicians, policies to empower clinicians and teamwork can help to create safer systems.