Clinical Alarms in a Gynaecological Surgical Unit: A Retrospective Data Analysis

Author:

Jämsä Juho O.1ORCID,Uutela Kimmo H.2,Tapper Anna-Maija13,Lehtonen Lasse14ORCID

Affiliation:

1. Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland

2. GE Healthcare, 00510 Helsinki, Finland

3. Hyvinkää Hospital, Helsinki and Uusimaa University Hospital District, 05850 Hyvinkää, Finland

4. Diagnostic Center, Helsinki University Hospital, 00260 Helsinki, Finland

Abstract

Alarm fatigue refers to the desensitisation of medical staff to patient monitor clinical alarms, which may lead to slower response time or total ignorance of alarms and thereby affects patient safety. The reasons behind alarm fatigue are complex; the main contributing factors include the high number of alarms and the poor positive predictive value of alarms. The study was performed in the Surgery and Anaesthesia Unit of the Women’s Hospital, Helsinki, by collecting data from patient monitoring device clinical alarms and patient characteristics from surgical operations. We descriptively analysed the data and statistically analysed the differences in alarm types between weekdays and weekends, using chi-squared, for a total of eight monitors with 562 patients. The most common operational procedure was caesarean section, of which 149 were performed (15.7%). Statistically significant differences existed in alarm types and procedures between weekdays and weekends. The number of alarms produced was 11.7 per patient. In total, 4698 (71.5%) alarms were technical and 1873 (28.5%) were physiological. The most common physiological alarm type was low pulse oximetry, with a total of 437 (23.3%). Of all the alarms, the number of alarms either acknowledged or silenced was 1234 (18.8%). A notable phenomenon in the study unit was alarm fatigue. Greater customisation of patient monitors for different settings is needed to reduce the number of alarms that do not have clinical significance.

Funder

Finnish Governmental Research Grant

Publisher

MDPI AG

Subject

Health, Toxicology and Mutagenesis,Public Health, Environmental and Occupational Health

Reference16 articles.

1. The Joint Commission (2022, March 24). National Patient Safety Goals Effective January 2022. Hospital Program. Available online: https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/2022/npsg_chapter_hap_jan2022.pdf.

2. (2023, February 13). EC 60601-1-8 (2006) + AMD1 (2012) + AMD2 (2020). Medical electrical equipment Part 1–8: General Requirements for Basic Safety and Essential Performance Collateral Standard: General Requirements, Tests and Guidance for Alarm Systems in Medical Electrical Equipment and Medical Electrical Systems. International Electrotechnical Commission. Available online: https://webstore.iec.ch/publication/59648.

3. A call to alarms: Current state and future directions in the battle against alarm fatigue;Hravnak;J. Electrocardiol.,2018

4. Clinical alarms and alarm fatigue in a University Hospital Emergency Department—A retrospective data analysis;Uutela;Acta Anaesthesiol. Scand.,2021

5. Patient monitoring alarms in the ICU and in the operating room;Schmid;Crit. Care,2013

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