Alarms Fatigue: How are you planning to meet this NPSG?

Nurses General Nursing

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TJC made alarms management a national patient safety goal. Also AACN came out with some suggestions to reduce alarms. fatigue.

National Patient Safety Goal on Alarm Management

How is your hospital planning to meet this NPSG? Who is leading the effort biomed or nursing?

Its interesting that we have 3 pages of discussion on this topic. Evidence that it is a vexing problem for nurses. However, I did not see any one saying that their hospital was working on it. I think hospitals are working on it but they have not consulted nurses. So suddenly one day you will see an announcement that hospital has instituted an alarms policy per NPSG. That would not be ideal solution in my view.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I told you how I delt with it.....however I am not in an acute care position right now. Unfortunately many facilities do not seek nursing in put at the bedside/

What are you looking for exactly?

I was looking for a few things:

- If hospitas are doing anything on this.

- How big a priority this is.

- Are they using and products/services to meet the goal

- Who is leading the charge (CNO, Biomed, CMO)

If that means that someone has to go in that room on that alert toddler....then so be it.

So who takes care of my other patients while I'm sitting in the toddler's room? Who's watching the monitor on my apnea baby that I can't tell when it goes off because the alert toddler is going off non-stop and I'm sitting in the toddler's room?

THAT is the problem with alarm fatigue. It's blamed on nurses being too LAZY to check the monitors. When the problem is patients that don't need to be monitored going off so we can't tell when one we need is going off. When my phone doesn't stop buzzing because of an awake toddler, I don't know that it's buzzing for the apnea baby that's actually having apnea. Unless we're going to get 1 on 1 staffing, it's not laziness, it's prioritizing.

Specializes in Critical Care.
I am always astonished when this discussion gets going that no one ever suggests the A-Number-One factor to address this: BETTER STAFFING. An intelligent and educated RN is the best monitor you have. You don't need IV alarms for completed volumes if you have RNs to check often enough for example. If you could avoid even IV pump alarms, that would be helpful. And of course Esme's description of how to actually use those functions that come with your arrhythmia monitoring software...your hospital paid good money for them, use them properly. Use your critical thinking skills to explain why.[/quote']

A. Freakin'. Men. I know ZERO nurses on my floor who do not take our alarms, bed alarms, call lights, etc. seriously...it's just that there aren't always enough of us to answer every single one when they are all going off at once. With that being said, I think a blasé environment is pervasive...if the attitude on my floor were less vigilant, I think laziness would prevail for some. The peer pressure of a high standard of care, DESPITE and not BECAUSE OF administrative pressure to do more with less, is why I still like my floor even though times are tough right now. I wouldn't want to be on a floor where people ignored the patients who "stay on the call light." Like Esme said, every light is a potential code.

Use your critical thinking skills to explain why.

I'm not allowed to use my critical thinking skills. It's outside my scope of practice.

Specializes in Pediatric Cardiology.

Our alarm settings have changed, looks like they follow the article's recommendations. Our O2 sat low is 88, down from 90% and there is a delay.

They can change the settings all they want but until doctors stop ordering tele and O2 on pts that don't need it we are going to continue to have issues on my floor. One service orders both for every pt. We've tried to speak with them and have gotten no where.

Specializes in Critical Care.
I wonder who or what system TJC will approve for adjusting alarm limits. I doubt they would approved of the patient's nurse doing that. I expect them to want alarm limits to be set by physician order considering their stance on medication range orders.

I'm familiar with their stance of medicare range orders, but not sure what you're referring to here.

Specializes in Critical Care.

They can change the settings all they want but until doctors stop ordering tele and O2 on pts that don't need it we are going to continue to have issues on my floor. One service orders both for every pt. We've tried to speak with them and have gotten no where.

We've changed our policy so tele, continuous O2, etc can be D/C'd by Nursing staff based on protocol criteria, regardless of how bad the MD wants it. There are specific criteria that have to be met, and have to be met continuously, for any type of monitoring, if they don't meet that we D/C it and leave them a note that their order was D/C'd.

Specializes in Critical Care.

We've changed our policy so tele, continuous O2, etc can be D/C'd by Nursing staff based on protocol criteria, regardless of how bad the MD wants it. There are specific criteria that have to be met, and have to be met continuously, for any type of monitoring, if they don't meet that we D/C it and leave them a note that their order was D/C'd.

That is awesome. I wish we could do that!

I'm not allowed to use my critical thinking skills. It's outside my scope of practice.

No, you're thinking of LPNs.

Specializes in Acute Care Pediatrics.
Are your monitors not capable of pedi/neonatal settings for rhythm interpretation? Sheesh.

I made a typo... but I meant to post BURPING baby. LOL! Smacking a baby on the back. We are not a tele unit, but a general med/surg and specialty unit. And to the other poster, these new policies are hospital/nursing led.

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