Telemetry issue Safe and Sound

[Nurse Pompom]

Telemetry issue.. In my hospital we now use safe and sound. I am seeing an increasing number of issues with it, but there are three main issues that I have noticed. I work in ICU.

First, there is no way to cancel an alarm for more than two minutes. My old system allowed us to cancel and alarm and if the monitored vital was to get WORSE, it would ring again (ie ring with O2 at 89%, cancel.. rings again if O2 is now 88%). It's been causing alarm fatigue, the alarms get ignored. Also, if more than one room alarms, it is now an issue because it might get missed since the first alarm is going off (same sound).

The other problem that I have noticed lately is with the software. You open the Safe and Sound program (why a different program btw???) to register the patient and it doesn't work. A few days ago I registered a patient myself, double checked that the patient showed up in the Safe and Sound program, and 10 minutes later another nurse came to register the patient so I found it odd and told her I had already done it. Second nurse told me she couldn't see patient as registered from the station. My manager also asked me to enter the pt and I said I had already done it and it wasn't working right but my feedback basically got dismissed. 

Third major issue is that when you plug the telemetry box in the portable monitor and then plug it back in the room main monitor, it erases all history! It is a major issue. Say you are wanting to look at it later and now there is no way to know what the vitals where during transport.

When I brought the alarm issue to the Safe and Sound representative, I was dismissed and told to "fix the patient" so the alarm wouldn't be an issue. First off, I work in ICU, patient do not have perfect vitals. I could lower the alarm threshold but I find it dangerous. Second, it doesn't fix the issue with multiple alarms going off at the same time. 

I don't know who to report the issue to. I don't mean in my hospital, but to which state/official. Who monitors the safety issues attached to hospital equipment? 

To me, this is huge.

[Okami_CCRN, BSN, RN]

New software is always going to have growing pains, you should be forwarding your concerns to the point person identified by your hospital; be that a representative or in-house IT. 

Regarding alarms, the AACN has provided exhaustive research and information regarding setting patient specific/customizable alarm parameters to decrease alarm fatigue. 

https://www.aacn.org/newsroom/practice-alert-outlines-alarm-management-strategies

[MunoRN, RN]

So this is a third party program that get's added to your monitoring system?  I can't find anything about a "safe and sound" monitoring system, the only thing I find is a vagus nerve stimulator by that name.

I would agree though, that if it's alarming for things that don't deserve an alarm, then that's dangerous and the issue needs immediate attention from administrators.

[Nurse Pompom]

On 5/14/2022 at 12:23 AM, MunoRN said:

So this is a third party program that get's added to your monitoring system?  I can't find anything about a "safe and sound" monitoring system, the only thing I find is a vagus nerve stimulator by that name.

I would agree though, that if it's alarming for things that don't deserve an alarm, then that's dangerous and the issue needs immediate attention from administrators.

Hello, it is a new telemetry system (the old one was better. I don't understand the logic behind it). "safe and sound" is spelled "safeNsound" (my bad for spelling it correctly) by Spacelabs. The alarms need to be adjusted. "fix the pt" isn't an acceptable answer. I will follow your advice.

On 5/13/2022 at 10:32 PM, Okami_CCRN said:

New software is always going to have growing pains, you should be forwarding your concerns to the point person identified by your hospital; be that a representative or in-house IT. 

Regarding alarms, the AACN has provided exhaustive research and information regarding setting patient specific/customizable alarm parameters to decrease alarm fatigue. 

https://www.aacn.org/newsroom/practice-alert-outlines-alarm-management-strategies

I'm definitely reporting the issue. Someone is going to end up hurt otherwise.

Thank you for this article. I will put it to good use.

[psu_213, BSN, RN]

First, any time the system does not register the patient correctly or deletes the memory, I would enter a safety occurrence (I'm totally blanking if this is the correct word--whatever your reporting system is for safety issues).  Hopefully your facility takes those seriously and will investigate.

For the issue of alarm fatigue: is it possible to change the parameters for when it alarms--for example, can you change the low limit to 85% for SaO2 for the COPD patient that always runs low?

[Robmoo, ADN, BSN, RN]

Adjust the alarm limits to be appropriate for the patient's clinical condition and then document.  Your old system did this autmoatically.  Under you new system you are going to have to use your clinical judgement to manage it.  There is nothing wrong with adjusting the alarms if it is appropriate for the patient's clinic condition and situation.  Just do you best to maintain your documentation so that if there is a question down the road you have CYA.

[Nurse Pompom]

On 5/20/2022 at 9:37 AM, Robmoo said:

Adjust the alarm limits to be appropriate for the patient's clinical condition and then document.  Your old system did this autmoatically.  Under you new system you are going to have to use your clinical judgement to manage it.  There is nothing wrong with adjusting the alarms if it is appropriate for the patient's clinic condition and situation.  Just do you best to maintain your documentation so that if there is a question down the road you have CYA.

I think you misunderstand. My old system would cancel an alarm if the vital monitored didn't move or was to get better. It would alarm again if the vital was to get worse. New system does not allow this. To stop an alarm, you have to lower the threshold - which can be OK in certain situations (ie COPD at 88%) but certainly you can see the issue behind this.