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Reducing Alarm Fatigue in Two Neonatal Intensive Care Units through a Quality Improvement Collaboration.
- Source :
-
American journal of perinatology [Am J Perinatol] 2018 Nov; Vol. 35 (13), pp. 1311-1318. Date of Electronic Publication: 2018 May 21. - Publication Year :
- 2018
-
Abstract
- Objective: To reduce nonactionable oximeter alarms by 80% without increasing time infants were hypoxemic (oxygen saturation [SpO <subscript>2</subscript> ] ≤ 80%) or hyperoxemic (SpO <subscript>2</subscript> > 95% while on supplemental oxygen).<br />Study Design: In 2015, a multidisciplinary team at Connecticut Children's Medical Center initiated a quality improvement project to reduce nonactionable oximeter alarms in two referral neonatal intensive care units (NICUs). Changes made through improvement cycles included reduction of the low oximeter alarm limit for specific populations, increased low alarm delay, development of postmenstrual age-based alarm profiles, and updated bedside visual reminders. Manual alarm tallies and electronic SpO <subscript>2</subscript> data were collected throughout the project.<br />Results: Alarm tallies were collected for 158 patient care hours with SpO <subscript>2</subscript> data available for 138 of those hours. Mean number of total nonactionable alarms per patient per hour decreased from 9 to 2 (78% decrease) and the mean number of nonactionable low alarms per patient per hour decreased from 5 to 1 (80% decrease). No change was noted in the balancing measures of percentage time with SpO <subscript>2</subscript> ≤ 80% (mean 4.3%) or SpO <subscript>2</subscript> > 95% (mean 23.7%).<br />Conclusion: Through small changes in oximeter alarm settings, including revision of alarm limits, alarm delays, and age-specific alarm profiles, our NICUs significantly reduced nonactionable alarms without increasing hypoxemia.<br />Competing Interests: None.<br /> (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
- Subjects :
- Female
Humans
Infant, Newborn
Male
Monitoring, Physiologic instrumentation
Monitoring, Physiologic methods
Monitoring, Physiologic standards
Oxygen Inhalation Therapy methods
Point-of-Care Testing organization & administration
Quality Improvement
Clinical Alarms standards
Intensive Care Units, Neonatal organization & administration
Intensive Care Units, Neonatal standards
Oximetry adverse effects
Oximetry instrumentation
Oximetry methods
Subjects
Details
- Language :
- English
- ISSN :
- 1098-8785
- Volume :
- 35
- Issue :
- 13
- Database :
- MEDLINE
- Journal :
- American journal of perinatology
- Publication Type :
- Academic Journal
- Accession number :
- 29783270
- Full Text :
- https://doi.org/10.1055/s-0038-1653945