Physician Assistant Program, Mayo Clinic, Rochester, Minnesota, USA.
Cardiovascular Research, Mayo Clinic, Rochester, Minnesota, USA.
BMJ Open Qual. 2023 Jul;12(3). doi: 10.1136/bmjoq-2023-002262.
Physiological monitoring systems, like Masimo, used during inpatient hospitalisation, offer a non-invasive approach to capture critical vital signs data. These systems trigger alarms when measurements deviate from preset parameters. However, often non-urgent or potentially false alarms contribute to 'alarm fatigue,' a form of sensory overload that can have adverse effects on both patients and healthcare staff. The Joint Commission, in 2021, announced a target to mitigate alarm fatigue-related fatalities through improved alarm management. Yet, no established guidelines are presently available. This study aims to address alarm fatigue at the Mayo Clinic to safeguard patient safety, curb staff burnout and improve the sensitivity of oxygen saturation monitoring to promptly detect emergencies.
A quality improvement project was conducted to combat minimise the false alarm burden, with data collected 2 months prior to intervention commencement. The project's goal was to decrease the total alarm value by 20% from 55%-85% to 35%-75% within 2 months, leveraging quality improvement methodologies.
February to April 2021, we implemented a two-pronged intervention: (1) instituting a protocol to evaluate patients' continuous monitoring needs and discontinuing it when appropriate, and (2) introducing educational signage for patients and Mayo Clinic staff on monitoring best practices.
Baseline averages of red alarms (158.6), manual snoozes (37.8) and self-resolves (120.7); the first postintervention phase showed reductions in red alarms (125.5), manual snoozes (17.8) and self-resolves (107.8). Second postintervention phase recorded 138 red alarms, 13 manual snoozes and 125 self-resolves. Baseline comparison demonstrated an average of 16.92% reduction of alarms among both interventions (p value: 0.25).
Simple interventions like education and communication techniques proved instrumental in lessening the alarm burden for patients and staff. The findings underscore the practical use and efficacy of these methods in any healthcare setting, thus contributing to mitigating the prevalent issue of alarm fatigue.
生理监测系统，如 Masimo，在住院期间使用，提供了一种非侵入性的方法来捕捉关键生命体征数据。这些系统在测量值偏离预设参数时会触发警报。然而，非紧急或潜在的虚假警报常常导致“警报疲劳”，这是一种感官超负荷的形式，可能对患者和医护人员都产生不利影响。2021 年，联合委员会宣布了一项通过改进警报管理来减轻与警报疲劳相关的死亡的目标。然而，目前还没有既定的指南。本研究旨在梅奥诊所解决警报疲劳问题，以保障患者安全，遏制员工倦怠，并提高氧饱和度监测的灵敏度，以便及时发现紧急情况。
开展了一项质量改进项目，以减少虚假警报的负担，在干预开始前收集了 2 个月的数据。该项目的目标是在 2 个月内将总警报值从 55%-85%减少到 35%-75%，采用质量改进方法。
2021 年 2 月至 4 月，我们实施了两项干预措施：（1）制定了一项评估患者连续监测需求的协议，并在适当的时候停止监测；（2）为患者和梅奥诊所的工作人员制作了关于监测最佳实践的教育标志。
基线时红色警报（158.6）、手动打盹（37.8）和自动消除（120.7）的平均值；第一阶段干预后，红色警报（125.5）、手动打盹（17.8）和自动消除（107.8）减少；第二阶段干预后记录了 138 个红色警报、13 个手动打盹和 125 个自动消除。基线比较显示，两次干预都有 16.92%的平均报警减少（p 值：0.25）。
像教育和沟通技巧这样的简单干预措施在减轻患者和医护人员的警报负担方面非常有效。这些发现突出了这些方法在任何医疗保健环境中的实际应用和有效性，从而有助于减轻普遍存在的警报疲劳问题。
