Feurer Angela L, Fitzpatrick Suzanna, Wise Barbara
School of Nursing, University of Maryland, College Park, MD, USA
School of Nursing, University of Maryland, College Park, MD, USA.
J Dr Nurs Pract. 2025 Apr 25. doi: 10.1891/JDNP-2024-0061.
Excessive generation of clinical alarms can result in ignored alarms and staff alarm fatigue putting patient safety at risk. A retrospective chart review reported an average of 19.44 alarms/patient/hour were generated on two 26-bed acute care units. Evidence supported implementing an alarm bundle. This quality improvement project aimed to implement an evidence-based bundle to reduce the number of nonactionable telemetry alarms occurring on two adult acute care inpatient units in a large community hospital. Weekly audits were used to assess workflow adherence. Run charts were used to show process adherence from audit findings. Adherence to daily electrode sticker changes was 80% ( = 118) and 75% ( = 110) for electronic medical record (EMR) documentation. Error with Lead V sticker placement occurred at 34% ( = 50) frequency. Once, a shift parameter documentation was 75% ( = 194) and 86% ( = 117) for customized parameter documentation. Frequency of nurse-driven heart rate parameter customization was 17% ( = 44). Adherence to the use of standby was 75% ( = 166). Safe clinical judgment was used in customizing parameters for patients experiencing heart rate significantly above or below parameter threshold. An evidence-based alarm bundle can be introduced safely and reduces nonactionable alarms in the adult acute care setting.
