by
Sean Ruck, Contributing Editor | July 20, 2011
From the July 2011 issue of HealthCare Business News magazine
Guidelines, conferences and seminars
It’s not just ECRI Institute making the push to silence the problem of alarm fatigue. The Association for the Advancement of Medical Instrumentation also has it on the docket with a summit slated for October to be co-hosted with ECRI and the American College of Engineers. The Joint Commission has also taken an interest and, the public’s awareness has been growing, helped greatly by the Boston Globe article and subsequent coverage by other news outlets — which are all good things in Graham’s estimation. “The more the media covers the issue, the more people will become aware and by talking about it and keeping it in the spotlight, I think it’s a good first step,” she says.
Manufacturing solutions
For manufacturers, the best thing they can do is make sure they’re openly communicating with professionals in the field. By speaking with bedside clinicians, they’re better able to determine where their energy should be focused.
Comprehensive customer education on the proper use of the machines and the management of the different alarm functions also plays a significant role. With a working knowledge of what the alarms are giving off warnings about, hospital staff will encounter fewer nuisance alarms and will be more prone to pay attention to the actionable ones.
OEMs are of course exploring device connectivity possibilities, but as Meyers points out, to provide an effective solution, companies would almost need to check each individual device to see how they work together.
Still, that hasn’t prevented some manufacturers from trying to improve upon design in order to create a safer and more peaceful experience for health care workers and patients alike.
Spacelabs Healthcare is one company that’s taking the challenge. According to Katherine Stankus, director of global strategic marketing, one of the main detail elements in the design of the company’s new XPREZZON monitor, introduced at the National Teaching Institute and Critical Care Exposition held this May in Chicago, was influenced by the growing concern about alarm fatigue.
“In terms of design, we decided to try to put more emphasis on visual alerts,” Stankus says.
While the unit still does offer audible alarms, it also offers visuals delivered by alarm lights embedded into the sides and back of the display. According to Stankus, the lights are totally invisible when alarm conditions aren’t present.
“The color of the light indicates the severity of the alarm,” says Stankus. “Walking by, a nurse can see that an alarm is in progress and the severity of the alarm — cyan for a low priority, yellow for a medium, and red for a high priority.”
Jose Morillo
ALARM FATIGUE. AN ENEMY EASY TO FIGHT
July 23, 2011 11:10
Never until now, nurses and medical personal was as expose to alarms detectors as now. Multiparameter monitors make possible measure almost any bilogocal parameter and asign, even automatically, alarms parameters for each one.
Two big problems are still present with alarms: 1.- Misadjusted alarms parameters that make it activate all time. 2.- Electrode, Transducers misconnections.
Both problems have solution. A correct alarm adjustment must consider the normal fluctuation of any parameter, human body is not a swiss clock. We must adjust alarms to levels that indicate a warning condition. It will mean a wider window of adjustment and a significative reduction of flase alarms (those alarms that haven't a clinical importance.
AN intelligent algoritm design can make monitors evaluate the alarm condition in a scale. Rarely the human parameters are independ one each other. Often a HR is follow or anteceded by an Arterial pressure variation, SpO2 or temperature variation. An "intelligent" monitor can evaluate, for example, HR from ECG and SpO2 at the same time two difference between an emergency condition and a loose transducer or electrode. it can consideer HR variation vs. Artery Pressure and/or SpO2 to determine a danger trend and launch a real alarm.
An intelligent ECG monitor can use as few as just 2 electrodes. Basically a ICU monitor is following Heart Rate, waveshape has no alarm itself. All alarm condition mean a frequency variation, soo 2 electrode are enough to check it. Always in case of doubt an ECG is maded with a full 12 electrodes ECG.
SpO2 and NIBP can be acopled. SUre a significative wave amplitude variation on SpO2 can mean an Arterial pressure variation. Monitor can launh a NIBP measurement to confirm BEFORE launch an alarm.
Parameter inter relations have no limits. A doctors and Biomedical team can make a new generation of Intelligents monitors.
Go ahead!
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