Beyond Simplistic Alarm Management
Despite countless initiatives by hospitals and an alarm management mandate from the Joint Commission1, the volume of medical device alarms continue to proliferate. In 2018, the Health Technology Foundation published results from its third iteration of a survey on clinical alarms and found “few improvements in perceptions of clinical alarm safety and management occurred in the past 10 years, and several positive trends noted between the 2006 and 2011 surveys were reversed on the 2016 survey. Most concerning was the near doubling of respondents indicating that their institutions had experienced an adverse patient event related to clinical alarms.”2 The decade-long data collection demonstrates that while technology has advanced, it is not being used as intended, resulting in an increase in noise and non-actionable alarms.
One of the major challenges in alarm management is separating clinically relevant alarms from non-actionable alarms (i.e., a sensor on a patient detached momentarily or brief self-correcting physiological responses). The simplistic threshold limits of physiologic devices, like patient monitors, pulse oximeters and capnographs, are highly susceptible to non-actionable alarms, which can make up 85-99% of all device-generated alerts.3,4