Bridi Adriana Carla, da Silva Roberto Carlos Lyra, de Farias Carolina Correa Pinto, Franco Andrezza Serpa, dos Santos Viviane de Lima Quintas
Escola de Enfermagem Alfredo Pinto, Universidade Federal do Estado Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Rev Bras Ter Intensiva. 2014 Jan-Mar;26(1):28-35. doi: 10.5935/0103-507x.20140005.
To define the characteristics and measure the reaction time of a health care team monitoring alarms in the intensive care unit.
A quantitative, observational, and descriptive study developed at the coronary care unit of a cardiology public hospital in Rio de Janeiro state (RJ). Data were obtained from the information collected on the patients, the monitoring used, and the measurement of the team's reaction time to the alarms of multi-parameter monitors during a non-participatory field observation.
Eighty-eight patients were followed (49 during the day shift and 39 during the night shift). During the 40 hours of observation (20 hours during the day shift and 20 hours during the night shift), the total number of monitoring alarms was 227, with 106 alarms during the day shift and 121 during the night shift, an average of 5.7 alarms/hour. In total, 145 alarms unanswered by the team were observed, with 68 occurring during the day shift (64.15%) and 77 during the night shift (63.64%). This study demonstrated that the reaction time was longer than 10 minutes in more than 60% of the alarms, which were considered as unanswered alarms. The median reaction time of the answered alarms was 4 minutes and 54 seconds during the day shift and 4 minutes and 55 seconds during the night shift. The respiration monitoring was activated in only nine patients (23.07%) during the night shift. Regarding the alarm quality of these variables, the arrhythmia alarm was qualified in only 10 (20.40%) of the day-shift patients and the respiration alarm in four night-shift patients (44.44%).
The programming and configuration of the physiological variables monitored and the parameters of alarms in the intensive care unit were inadequate; there was a delay and lack of response to the alarms, suggesting that relevant alarms may have been ignored by the health care team, thus compromising the patient safety.
确定重症监护病房中医疗团队监测警报的特征并测量其反应时间。
在里约热内卢州（RJ）一家心脏病公立医院的冠心病监护病房开展了一项定量、观察性和描述性研究。数据来自于对患者收集的信息、所使用的监测设备，以及在非参与性现场观察期间对团队对多参数监护仪警报的反应时间的测量。
共对88名患者进行了跟踪（白班期间49名，夜班期间39名）。在40小时的观察期内（白班20小时，夜班20小时），监测警报总数为227次，其中白班106次，夜班121次，平均每小时5.7次警报。总共观察到145次团队未应答的警报，其中白班68次（64.15%），夜班77次（63.64%）。本研究表明，超过60%的警报反应时间超过10分钟，这些警报被视为未应答警报。应答警报的中位反应时间白班为4分54秒，夜班为4分55秒。夜班期间仅9名患者（23.07%）的呼吸监测被激活。关于这些变量的警报质量，心律失常警报在白班患者中仅10例（20.40%）符合要求，呼吸警报在夜班患者中有4例（44.44%）符合要求。
重症监护病房中监测的生理变量的编程和配置以及警报参数不充分；对警报存在延迟和缺乏响应，这表明医疗团队可能忽略了相关警报，从而危及患者安全。
