How to manage the many alarms that the bedside nurse must assess? "The Joint Commission has identified alarm management as a national patient safety goal and requires hospitals to take action to reduce unnecessary alarms as a condition of accreditation." allnurses.com's Community Manager, Mary Watts, BSN, RN had the opportunity to interview Halley Ruppell, PhD, RN and Stacy Jensen, CNS at NTI. Some issues they discussed included: Tailoring the alarm setting to the individual patient and the disease process. For instance some children with congenital heart issues experience a "normal" SpO2 saturation below the standard so setting the parameters lower results in fewer nonactionable alarms Actual alarm management teams including engineers have come together to enact age-appropriate alarm settings that would somewhat standardize parameters. Placement of electrodes, skin prep prior to placement, and the amount of pressure applied to skin are all part of the monitoring process SpO2 sensors being applied correctly and the use of the correct sensor on the correct body part are key to proper management of alarms also Quality improvement activities are very important to the care of the critically ill patient; for both pediatric and adult patients. Nonactionable alarm overload can result in nurses actually not hearing alarms as well as disregarding alarms. With many "false alarms,” this results in less response to the alarm increasing the chance of missing an actionable alarm. The process alarm alert was updated in 2018. Here is the link to the practice alert. During the interview, it was discussed that there is not a lot of research involving the differences between pediatric and adult critical care monitoring. This has resulted in a standardized monitoring system for both adults and pediatrics which isn't always individualized. It is imperative that clinicians order appropriate monitoring for patients and that monitors are not overused. This can also lead to alarm fatigue. Another issue that was discussed was buy-in from the bedside nurses. The feedback received after the initiative was published involved hard data. This provided the bedside nurse with evidence-based information proving the efficacy of the practice alert. Listening to fewer alarms really engaged the nurses and brought awareness of alarm fatigue to the bedside nurse. This is important also for the families bedside and promoted the engagement of both staff and visitors. Change in practice can sometimes become burdensome for the bedside nurses but with evidence-based information, you can obtain more engagement. It was eye-opening for nurses to realize that they didn't hear all the alarms. It's a sensory overload type of situation. Leadership must also recognize the need for change. Per AACN; "The strategies for nursing leaders include the following: Establish an interprofessional team to gather data and address issues related to alarms Develop unit-specific default parameters and alarm management policies Provide initial and ongoing education on monitoring systems and alarm management for unit staff Develop policies and procedures for monitoring only those patients with clinical indications for monitoring" Yet another piece of this project was a collaboration between the researchers and the industry that makes the monitors. It is very important to involve business leaders and engineers. 4 Down Vote Up Vote × About traumaRUs, MSN, APRN Trauma Columnist 88 Articles 21,256 Posts Share this post Share on other sites