Alarm fatigue is a growing concern in our healthcare system and nursing care today. Studies have shown that as many as 86% to 99.4% of alarms that sound by physiological monitors are false-positives that do not result in a change in patient care (Graham, 2010). The primary objective of physiological alarms on the nursing units is to notify the clinicians to a patient’s deteriorating status in order for timely and proper action to be taken before an adverse outcome occurs. Due to the high volume of false-positive alarms, over time, these alarms start to be taken less seriously, slowing reaction time to a possible patient’s problem, or being ignored all together. Alarm fatigue can be challenging due to the fact that it involves both technical …show more content…
Customization allows for patient’s to have tailor made, detailed care and thought put into their healthcare experience and allows for a better outcome. The primary problem with alarm fatigue is the sheer number of ‘nuisance’ alarms caused by clinicians using the factory or hospital based default settings. These default settings do not take into account the type of patient that a clinician is caring for or the degree or severity of their condition. Customizing alarms, instead of using the default settings provided on the equipment, ensures that alarms are valid, actionable, and able to be used to ensure the patient remains free from poor outcomes (Cvach, 2012; DeVaux, 2015; Graham, 2010). The problem with using default alarm settings on a patient, is that when the alarms are triggered, nurses become immune to them, resulting in delayed response times, due to the fact that up to 70% of the alarms that go off are threshold alarms for preset limits (Bridi, 2014). Customization of physiological alarms is the best approach to improve the growing problem of alarm fatigue as evidenced by the reduction of total number of alarms, provides an early warning to potential critical situations, and leading to actionable and clinically significant …show more content…
The problem with lack of monitor education is that nurses continue to use default monitor settings and improperly applying physiological monitors which lead to an increased number of nuisance alarms adding to the growing problem of alarm fatigue. Studies found that a crucial component of tackling alarm fatigue was to educate the nursing staff on monitor settings as well as proper machine usage (Bridi, 2014; Graham, 2010; Devaux, 2015). This included education on individualizing alarm parameters, levels of alarms and their specific alarm tones, preparing the patient’s skin, lead placement, high and medium priority arrhythmia alarms, and QTC monitoring (Bridi, 2014; Graham, 2010; Devaux, 2015). Further research and investment of time is needed on monitor and alarm education as evidenced by the positive and motivated outlook on monitor education in order to decrease monitor alarms on the unit as well as establishing alarm parameters so alarms that occur are purposeful and
Respiratory assessment is a significant aspect of nursing practice. According to the National Institute for Health and Care Excellence, respiratory rate is the best indicator of an ill patient and it is the first observation that will demonstrate a problem or deterioration in condition (Philip, Richardson, & Cohen, 2013). When a respiratory assessment performed effectively on a patient, it can result in upholding patient’s comfort and independence in progress of symptom management. Studies have acknowledged that in spite of the importance of the respiratory rate (RR) it is documented rarely than the other vital signs in the hospital settings (Parkes, 2011). This essay will highlight the importance of respiratory assessment and discuss why nurses
Noticeable indications of deterioration have been shown in numerous patients few hours prior to a critical condition (Jeroen Ludikhuize, et al.2012). Critical condition can be prevented by recognizing and responding to early indications of clinical and physiological deterioration ( kyriacosu, jelsma,&jordan (2011). According to NPSA (2007) delay in responding to deteriorating vital signs have been defined as an complication resulting in prolonged length of stay, disability or death, not attributed to the patient's underlying illness procedure along but by their health-care management ( Baba-Akbari Sari et al. 2006; Helling, Martin, Martin, & Mitchell, 2014). A number of studies demonstrate that changes or alterations in a patient’s
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.
Nurses hate it when patients are constantly turning their call lights on. The nurse feels like they are continuously in and out of that room for every little thing. Patients hate it when they wait a long time for someone to show up after pressing their call light. The patient begins to feel that they are not being take care of well and are being ignored. Patient satisfaction surveys state that one of the top complaints from patients were call lights not being answered in a timely manner. There has been evidence to prove that if facilities implement hourly rounding into their daily routine patient satisfaction goes up and call light use is greatly reduced. It is also proven if patient satisfaction goes up more nurses are satisfied with their job performance and can take care of their patients better.
Today it is a requirement of the Joint Commission for all healthcare facilities to have a fall-prevention program in place. Facilities are also required to conduct an ongoing evaluation of the program (Hubbartt, Davis & Kautz, 2013). Most prevention programs include the use of a bed alarm, but can bed alarms alone prevent falls? This paper will investigate the use of a bed alarm being used as the only tool to prevent falls. It is often found that even when a bed alarm is sounded the patient has already fallen before any nursing personal can get into the room. This paper will also investigate the use of other prevention measures that can be used independently or in conjunction with bed alarms to work toward decreasing the number of falls and the related change theory that would work best to implement this change in practice. Nurses are leaders and should always be working to identifying and changing problems that appear to be evident with keeping in mind the best interest of the patient, their families, and the nursing staff.
Tzeng H. & Yin C. (2010) Nurses' response time to call lights and fall occurrences. MEDSURG
Working as a professional registered nurse in the hospital, I realized how nurses struggle to find balance between devoting the time charting on the computer and spending time taking care of the patients. Moreover, I’ve seen nurses where they get discouraged trying to find this balance between patients and charting. As a bedside nurse, I would love nothing, but to tend to the needs of my patients. The length of time consume on electronic charting all day, take the very essence of bedside nursing away from nurses, which is caring. Reducing the time of nurses being occupied on charting by eliminating redundant tasks while conforming to their standard, are the changes I would like to make. These are a few of the reasons why I wanted to pursue a degree in informatics. I would advocate for nurses everywhere and to become an instrument in providing them a better electronic health system to work on. Pursuing the degree in nursing informatics will benefit me in
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...
Human factors are derived from construction and adapted to a system of development in health care by carefully examining the relationship between people, environment, and technology. The consideration of human factors acknowledges the capability or inability to perform a precise task while executing multiple functions at once. Human factors provide an organized method to prevent errors and create exceptional efficiency. Careful attention must be exercised in all levels of care such as the physical, social, and external environment. It is also vital to carefully consider the type of work completed and the quality of performance. Applying human factors to the structure of healthcare can help reduce risks and improve outcomes for patients. This includes physical, behavioral, and cognitive performance which is important to a successful health care system that can prevent errors. A well-designed health care system can anticipate errors before they occur and not after the mistake has been committed. A culture of safety in nursing demands strong leadership that pays attention to variations in workloads, preventing interruptions at work, promotes communication and courtesy for everyone involved. Implementing a structure of human factors will guide research and provide a better understanding of a nurse’s complicated work environment. Nurses today are face challenges that affect patient safety such as heavy workloads, distractions, multiple tasks, and inadequate staffing. Poor communication and failure to comply with proper protocols can also adversely affect patient safety. Understanding human factors can help nurses prevent errors and improve quality of care. In order to standardize care the crew resource management program was
...managing the environment for the benefit of the patient to help reduce risk factors. Supportive measures by the nurse such as attention to noise reduction and lighting should be implemented to all patient care settings. The nurse should be proficient in their assessment method. The bedside nurse is in a front-line position to manage and prevent delirium.
Safe nurse-patient ratio is a complex issue debated on for many years. Due to inadequate staffing registered Nurses are faced with high patient ratios, and nurse burn out everyday. According to the American Nurses Association, “Massive Reductions in nursing budgets combined with, the challenges presented by a growing nursing shortage have resulted in fewer nurses working longer hours for sicker patients. This situation compromises care and contributes to the nursing shortage by creating an environment that drives nurses from the bedside”. (2012) Through the nursing process, the essential role of the Registered Nurse is to assess, diagnose, and plan based on outcomes, implement and evaluate the effectiveness of nursing care. However, it is not realistic to thoroughly implement these core guidelines in a safe and effective way, when you are
The Quality and Safety Education for Nurses (QSEN’s) goal is to prepare future nurses with the knowledge, skills, and attitudes (KSAs) that are needed to continuously improve the quality and safety of the healthcare systems within which they work. QSEN focuses on six main competencies; patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. As we have learned in earlier classes these competencies and their KSAs offer a base to help us and other nurses as we continue our education and become RNs. As we will learn in this class these KSAs go hand in hand with health assessment.
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.
Several consequences of high nursing workload have been proven to hinder the quality of patient care. Carayon and Gurses’s research (2008) indicates that heavy workload can contribute to errors, shortcuts, guideline violations, and poor communication with physicians and other providers, thus compromising the quality and safety of patient care. In addition, the research not only implies that patients may not receive proper care, but also they can experience less satisfaction with
With the introduction of the age of computers, the nursing profession has seen a transition from the manual to automated methods of record keeping and even patient management. With the introduction of new technology even in monitor systems within the hospitals, nurses are compelled to increase their scope of learning in order to cope with the changes. Intensive care unit equipment are highly sophisticated which only increases the pressure on the nurse as a learner (Urquhart, Currell, Grant & Hardiker). This explicitly shows that nursing is a