Introduction
Alarms sound around-the-clock in acute care settings, subjecting staff to a constant barrage of noises in the workplace. Alarms were designed to alert providers of abnormal values; unfortunately, because of the high sensitivity of these devices, there is very low specificity. Low specificity coupled with the human factor compromises patient safety. When alarms are missed or when there is a delay in response, alarm fatigue is often to blame. This paper summarizes the factors contributing to alarm fatigue, the consequences of alarm fatigue, and the evidence-based interventions used to address alarm fatigue that were found within the literature. The paper closes with the application of the Quantum Leadership theory to the implementation process for one of the recommended evidence-based interventions found within the research.
Contributing Factors
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Although nurses and other health care workers can control only a small percentage of false alarms that lead to alarm fatigue, staff can help reduce the number of these alarms and increase patient safety through the application of the aforementioned evidence-based interventions. As supported by the literature, nurse leader-managers must make addressing alarm fatigue a top priority in their units and hospitals. Alarm fatigue is a serious issue in this age of information and will only become more relevant as complex technology becomes more and more standard in an increasing number of hospitals. Without more research and new developments in alarm algorithms, alarm fatigue will continue to be a significant problem. Because medical device companies are pressured to develop products with extremely high sensitivity to reduce their own liability, this barrier is a difficult one to address (Imhoff, 2009). Despite this momentous obstacle, nurses can still advocate for better alarm management systems and for greater advancement in this area of patient
the surface structure of these poems appears simplistic, but subtle changes in tone or gesture move the reader from the mundane to the sublime. In an attempt to sleep, the speaker in "Insomnia" moves from counting sheep to envisioning Noah's arc to picturing "all the fish in creation/ leaping a fence in a field of water,/ one colorful species after another." Collins will tackle any topic: his subject matter varies from snow days to Aristotle to forgetfulness. Collins relies heavily on imagery, which becomes the cornerstone of the entire volume, and his range of diction brings such a polish to these poems
Similar to Global Positioning Systems (GPS) provide drivers with directions, detours, alternative routes, and alerts, Clinical Decision Support (CDS) systems provide health care professionals with guidance for important decisions associated with patient care. These systems have many capabilities including synthesizing patient information, suggesting diagnostic tests, providing alerts for life-threatening situations, recommending treatment options, and providing relevant evidence and best practices. Nonetheless, just as GPSs, CDS systems are not usually perfect as evident in the ongoing evolution of their design specifications and functionalities. Some of the major issues that are still evolving for CDS systems include alert fatigue and integration of evidence-based practice (EBP) resources and clinical guidelines. One of the major areas that can benefit from the adoption and integration of clinical decision support systems is community health nursing. These systems can be used together with evidence-based medicine to help improve the quality of health and patient care in community health nursing.
While nurses are working on a floor there are many different machines that have alarms such as IV pumps, ventilator machines, ECG’s, vital machines, call lights, and pagers. New nurses have shown a lack of response efforts to combat these alarms from a proposed desensitization and sensory overload of the alarm noise (Cvach, 2012). This is a patient safety concern due to what the alarms purpose is which in turn leads to varying amounts of potentially severe consqeunces if not answered promptly. Between 2009 and 2012 the joint commission stated that there were 80 patient deaths, 13 permanent losses of function, and 5 events that led to extended hospital stays (Horkan, 2014). It is important for nurses to recognize alarm fatigue and find interventions to help keep patients from being injured.
Hospitalized patients are often hooked up to monitoring devices such as heart monitors, which monitor the electric activity of the heart, or connected to a physiological monitor so their vital signs are constantly being measured. These monitors are intended to continuously assess the patients’ status, and alarm if the patients’ status drops below what is considered normal. The increased use of monitoring devices has created a new phenomenon known as alarm fatigue. According to the ECRI institute (2011), “alarm fatigue occurs when the sheer number of alarms overwhelms staff and they become desensitized to the alarms resulting in delayed alarm response and missed alarms-often resulting in patient harm or even death.” Alarm fatigue has become a major problem within the nursing community and has already had a negative impact on patient safety. Due to the adverse effects alarm fatigue is having on quality patient care, there has been a call to action to find solutions that may deter alarm fatigue. Evidence-based practices involving quality improvement initiatives have been put into effect. The problem has also gained national attention from such institutions as the Food and Drug Administration (FDA) and The Joint Commission (TJC).
Following the QSEN model, this problem is a concern that falls under the safety category. The Institute of Medicine defines safety as, “minimizes risk of harm to patients and providers through both system effectiveness and individual performance” (IOM, 2003). A nurse manager must address this problem because without nurses who are able to work, patients cannot be taken care of in a safe and effective way. As a nurse manager, it would be ...
The nursing profession is a profession where people put their trust in you to provide care that is not only effective, ethical, and moral, but safe. Not all health situations are simple or by the book. Not all hospitals have the same nurse-patient ratios, equipment, supplies, or support available, but all nurses have “the professional obligation to raise concerns regarding any patient assignment that puts patients or themselves at risk for harm” (ANA, 2009). When arriving at work for a shift, nurses must ensure that the assignment is safe for not only the patients, but also for themselves. There are times when this is not the situation. In these cases, the nurse has the right to invoke Safe Harbor, because according the ANA, nurses also “have the professional right to accept, reject or object in writing to any patient assignment that puts patient or themselves at serious risk for harm” (ANA, 2009).
In the recent past, nursing has come to the forefront as a popular career amongst students across the globe. The demand for nurses has kept increasing gradually over the years. In fact, the number of registered nurses does not meet the demand of the private and public health sector. This phenomenon has resulted in a situation where the available registered nurses have to work extra hours in order to meet the patients’ needs. With this in mind, the issue of nurse fatigue has come up as a common problem in nursing. According to the Canadian Nurses Association (CNA), nurse fatigue is “a feeling of tiredness” that penetrates a persons physical, mental and emotional realms limiting their ability to function normally. Fatigue does not just involve sleepiness as has been assumed before. It involves utter exhaustion that is not easily mitigated through rest. When nurses ignore the signs of fatigue, they risk the development of chronic fatigue and other health problems that may not be easily treated. Additionally, fatigue may cause nurses to lose more time at work as they may have to be away from work for several days to treat it. The issue of nurse fatigue has permeated the nursing profession to the extent of causing errors in the work performed by nurses. Fatigue causes a decrease in a nurse’s ability to make accurate decisions for themselves and their patients. It is therefore important to find ways to curb nurse fatigue such that it is no longer a problem. Nurse fatigue is a danger to the patients, organizations and to the nurses themselves and must be mitigated adequately.
Tzeng H. & Yin C. (2010) Nurses' response time to call lights and fall occurrences. MEDSURG
Patients Safety is the most crucial about healthcare sector around the world. It is defined as ‘the prevention of patients harm’ (Kohn et al. 2000). Even thou patient safety is shared among organization members, Nurses play a key role, as they are liable for direct and continuous patients care. Nurses should be capable of recognizing the risk of patients and address it to the other multi disciplinary on time.
My behavior change project was attempting to have a more regular sleep schedule. This project was challenging to me because I typically have a hard time falling asleep and waking up, and I usually procrastinate leading to many late nights. I think the biggest challenge that this change presents is slipping up and staying up late or sleeping or napping can mess up your whole cycle of sleeping and take an even longer amount of time to correct. In the beginning keeping track of my sleep felt good because I knew that I was getting enough sleep and it gave me an excuse to stop studying and go to bed. Ultimately though, making a conscious effort to track my sleep and get more sleep was more stressful than jut letting sleep happen naturally.
Nurses are fundamental to the process of implementation of certain systems used in the workplace. Nurses should be allowed to have input and suggestions regarding what works and what doesn’t when it comes to those systems, whether it is the EMR, healthcare organization systems, or even the use of point of care systems (Mitchell, 2011). This allows for open collaboration between the nurses and information technology to come up with solutions and user friendly applications when needed. The technology world is ever changing and with that comes new ways to monitor and take care of our patients.
The staff will now have to rely heavily on technology to monitor delicate vital signs and feeding schedules as well as charting assessments. The large panoramic view of a room has been replaced with walls and a nurse watching a com...
Patient’s safety will be compromised because increase of patient to nurse ratio will lead to mistakes in delivering quality care. In 2007, the Agency for Healthcare Research and Quality (AHRQ) conducted a metanalysis and found that “shortage of registered nurses, in combination with increased workload, poses a potential threat to the quality of care… increases in registered nurse staffing was associated with a reduction in hospital-related mortality and failure to rescue as well as reduced length of stay.” Intense workload, stress, and dissatisfaction in one’s profession can lead to health problems. Researchers found that maintaining and improving a healthy work environment will facilitate safety, quality healthcare and promote a desirable professional avenue.
The overall goal for the Quality and Safety Education for Nurses (QSEN) plan is to meet the challenge of educating and preparing future nurses to have the knowledge, skills and attitudes that are essential to frequently progress the quality and safety of the healthcare systems in the continuous improvement of safe practice (QSEN, 2014).Safety reduces the possibility of injury to patients and nurses. It is achieved through system efficiency and individual work performance. Organizations determine which technologies have an effective protocol with efficient practices to support quality and safety care. Guidelines are followed to reduce potential risks of harm to nurses or others. Appropriate policies
Why is the system a better approach?. This is because, it gives the people involved the full peace of mind needed for them to prolong. The first alert medical alert systems, happens to be like a first aid that is given to a patient. They are mentally, affecting their recipients positively; when they are perfectly introduced in the lives of their subsets their r...