Knowledge Bank

Telemetry alarms are an invaluable tool for healthcare providers. The goal of an alarm is to accurately alert the proper healthcare provider when a potential issue arises with one of their patients. This is not always the case, however. For example, the rate of actionable alarms has been shown to range from anywhere between <1% to 34%. Exposure to alarms that do not convey relevant information can lead to undesirable consequences, chiefly among them a higher alarm response time by nurses. To address this problem, a hospital system implemented various changes to the alarms. For example, some of these changes included changes to the alarm tone itself, other changes included suppression of the alarm for 20 seconds. The effect these changes had on the duration of alarm response time was measured. In preliminary research, four alarms stood out as most and least improved. The four alarms were VFIB/VTACH, SPO2 LO, Staff Emergency, and Code Blue. The alarm duration data from these four alarms was retrieved from a cardiac hospital in the hospital system. Alarm duration 6 months before and 6 months after the intervention was analyzed using box and whisker plots and xbar-s charts. The Code Blue and Staff Emergency alarms were both seen as improving the most, while the SPO2 LO and VFIB/VTACH alarms were both seen as improving the least. An additional ad hoc analysis showed there was also a high variability in performance of the VFIB/VTACH. Some explanations for high variability in this alarm could be brittleness of the recognition pattern. Best practices learned from the highest performing units could be shared with the lowest performing units in order to improve outcomes.