Palchaudhuri Sonali, Chen Stephanie, Clayton Elaine, Accurso Anthony, Zakaria Sammy
Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Providers for Responsible Ordering, Johns Hopkins Medicine, Baltimore, Maryland.
Johns Hopkins Bayview Medical Center, Baltimore, Maryland; Providers for Responsible Ordering, Johns Hopkins Medicine, Baltimore, Maryland; Kaiser Permanente San Francisco, San Francisco, California.
J Hosp Med. 2017 Jun;12(6):447-449. doi: 10.12788/jhm.2754.
Cardiac telemetry, designed to monitor hospitalized patients with active cardiac conditions, is highly utilized outside the intensive care unit but is also resource-intensive and produces many nonactionable alarms. In a hospital setting in which dedicated monitor watchers are set up to be the first responders to system-generated alerts, we conducted a retrospective study of the alerts produced over a continuous 2-month period to evaluate how many were intercepted before nurse notification for being nonactionable, and how many resulted in code team activations. Over the 2-month period, the system generated 20,775 alerts (5.1/patient-day, on average), of which 87% were intercepted by monitor watchers. None of the alerts for asystole, ventricular fibrillation, or ventricular tachycardia resulted in a code team activation. Our results highlight the high burden of alerts, the large majority of which are nonactionable, as well as the role of monitor watchers in decreasing the alarm burden on nurses. Measures are needed to decrease telemetry-related alerts in order to reduce alarm-related harms, such as alarm fatigue. Journal of Hospital Medicine 2017;12:447-449.
心脏遥测技术旨在监测患有活动性心脏疾病的住院患者，在重症监护病房之外被广泛使用，但它也耗费资源，且会产生许多无需采取行动的警报。在一家设有专门的监测值班人员作为系统生成警报的第一响应者的医院里，我们对连续两个月期间产生的警报进行了一项回顾性研究，以评估有多少警报在通知护士之前因无需采取行动而被拦截，以及有多少警报导致了急救团队的启动。在这两个月期间，该系统产生了20775条警报（平均每天5.1条/患者），其中87%被监测值班人员拦截。所有关于心搏停止、心室颤动或室性心动过速的警报均未导致急救团队的启动。我们的研究结果凸显了警报的高负担，其中绝大多数无需采取行动，以及监测值班人员在减轻护士警报负担方面的作用。需要采取措施减少与遥测相关的警报，以减少与警报相关的危害，如警报疲劳。《医院医学杂志》2017年；12:447 - 449。
