1. The Nurse’s Perspective and responsibilities
Alarm Fatigue:
The Nurse’s Perspective and responsibilities

2. What is Alarm Fatigue?
For staff on the floor, it’s too easy to relate to
Staff can experience as many as 700 alarms per patient per day
Monitor alarms seem to be constantly beeping, honking, chirping, etc…
Nurses and other staff become desensitized to the alarms
Alarms become background noise instead of a serious alert.

3. What contributes to alarm fatigue?
Nuisance alarms related to:
Improper lead placement for telemetry
Patient movement and artifact
Poor signal strength/batteries low
Excessive monitoring, i.e. monitoring patients who do not need to be monitored
Nurses and other staff silencing alarms
Turning down the volume on the monitor
Improperly set parameters
Lack of policy regarding monitors and alarms

4. What are the consequences of alarm fatigue?
From January 2009 – June 2012 the Joint Commission reported:
At least 80 alarm related deaths
At least 13 serious alarm related injuries
Injuries and deaths were related to falls, medication errors, delay in response, and ventilator use
Top technology hazard for 2013

5. What can we as nurses do to prevent alarm fatigue?
Know the policy regarding the monitors
Know who is allowed to silence alarms and change a patient’s parameters
Set appropriate parameters for each individual patient.
For example, know the goal oxygen level for a patient with COPD and set alarms around that range
Prevents unnecessary alarming and habits of silencing
Follow proper lead placement for telemetry
Ensure equipment is working properly and receiving a good reading
Change batteries in an appropriate time frame
Pause the alarm for a patient that is going to be disconnected for long time – in the shower, off the floor, etc…

6. What are impairs nurses from effectively responding to alarm fatigue?
High patient – nurse ratio
Busy assignment
Lack of evidence based practice regarding alarm fatigue – relatively new issue
Need for better monitoring technology.
Need for a multidisciplinary approach
While nurses need to embrace a cultural change regarding monitor alarms, it is not only a nursing problem!

7. Reflective Note
In nursing, many policies are covered via in-services. I imagined that teaching regarding alarm fatigue would be a great subject for an in-service. The teaching is geared towards the clinical staff on a nursing floor. The audience could potentially be my peers, subordinates, or superiors. In addressing this audience, I kept in mind that the information needed to presented clearly and quickly, as many in- services are squeezed into the work day or done during lunch breaks. No one ever really wants to or has time to sit through a long presentation. I organized the information in bullet points so it is easy to read and easier to remember, as compared to a paragraph. I included graphics to keep the audiences focus, but tried to limit them as to not be distracting.

8. References
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