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Team-Based Intervention to Reduce the Impact of Nonactionable Alarms in an Adult Intensive Care Unit

Yeh, Justin BA; Wilson, Ruth MHS, RNC-NIC, NE-BC; Young, Lufei PhD, APRN; Pahl, Lisa MSN, RN; Whitney, Steven MSN, RN, CCRN; Dellsperger, Kevin C. MD, PhD; Schafer, Pascha E. MD

doi: 10.1097/NCQ.0000000000000436
Original Article: PDF Only
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Background: Nonactionable alarms comprise over 70% of alarms and contribute a threat to patient safety. Few studies have reported approaches to translate and sustain these interventions in clinical settings.

Purpose: This study tested whether an interprofessional team-based approach can translate and implement effective alarm reduction interventions in the adult intensive care unit.

Methods: The study was a prospective, cohort, pre- and postdesign with repeated measures at baseline (preintervention) and post-phase I and II intervention periods. The settings for the most prevalent nonactionable arrhythmia and bedside parameter alarms were adjusted during phases I and II, respectively.

Results: The number of total alarms was reduced by 40% over a 14-day period after both intervention phases were implemented. The most prevalent nonactionable parameter alarms deceased by 47% and arrhythmia alarms decreased by 46%.

Conclusions: It is feasible to translate and sustain system-level alarm management interventions addressing alarm fatigue using an interprofessional team-based approach.

Department of Medicine (Mr Yeh) and Division of Cardiology, Department of Medicine (Drs Dellsperger and Schafer), Medical College of Georgia at Augusta University, Augusta; Augusta University Medical Center, Children's Hospital of Georgia, Augusta (Ms Wilson); College of Nursing, Augusta University, Augusta, Georgia (Dr Young); Healthcare Transformation Services, Philips Healthcare, Philadelphia, Pennsylvania (Ms Pahl); and Mission Hospital, Asheville, North Carolina (Mr Whitney).

Correspondence: Justin Yeh, BA, College of Nursing, Augusta University, 987 St Sebastian Way, Augusta, GA 30912 (juyeh@augusta.edu).

We acknowledge the members of the Clinical Alarm Management Work Group for their contributions to this project and Philips Healthcare for their partnership and assistance.

Lisa Pahl is a full-time employee at Philips as Principal and Practice Operations Lead, and she participates on the Association for the Advancement of Medical Instrumentation task forces related to clinical alarms. The remaining authors declare no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com).

Accepted for publication: July 22, 2019

Published ahead of print: September 10, 2019

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