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
Unlike traditional alarm management systems that are dependent on alarms triggered by medical devices, alarm surveillance starts with comprehensive, continuous patient data to enable advanced smart alarms and a more holistic view of the patient status, while actively filtering out nuisance and non-clinically actionable alarms from devices. Alarm Surveillance also gives care teams easy access to real-time patient data, including live streaming waveforms when available from the device.
Here’s how it works. The Alarm Surveillance system provides the ability to create unique alarms by taking into consideration various features that are observed in the medical-device-originating raw data, versus simply filtering alarms as issued by bedside patient care medical devices (i.e. Limit Alarms). This enables the platform to issue custom alarm signals that are independent of the medical device. Further, the system enables the creation of signals that are more clinically actionable by placing the power of alarm signal customization and tailoring in the hands of the bedside clinician. Therefore, these alarm signals are more clinically relevant to the specific patient condition, staff workflow, and context of the clinical environment.
With Capsule’s alarm surveillance application, individualized alarms can be set on a per-patient basis. The alarms can also be viewed, escalated, and acknowledged. However, simply acknowledging and viewing the alarms is not enough. Within Capsule there is a means for creating and setting alarm limits for remote clinicians that are distinct from the alarm limits on the medical devices. Capsule provides remote viewing and management of alarm settings without affecting the default settings on the individual patient care medical device at the bedside. Moreover, hospitals and health systems can utilize Capsule’s alarm analysis capabilities to determine the best configuration of alarms and alarm settings including the medical devices at the bedside and what is sent to the clinician’s phone or mobile device. This helps in reducing non-actionable alarms and alarm fatigue.