Health IT, Hospitals

How one hospital reduced alarms without undermining patient safety

A recent study published Biomedical Instrumentation & Technology shows how Virtua Memorial Hospital cut down on the number of overall alarms but didn't threaten patient care.

data, patient, medical records, health data, healthcare data

Keeping patient safety top of mind is crucial, and vigilance is a must in the hospital environment.

But intricately tied to safety concerns is the hazard of alarm fatigue. Being exposed to a high number of alarms can desensitize clinicians to alarms, thereby putting patient safety at risk.

The issue is a complicated one to solve, but a study published in Biomedical Instrumentation & Technology examines one type of solution.

The research, which was a follow-up to an initial pilot study, took place at Mount Holly, New Jersey-based Virtua Memorial Hospital. It included 25 sleep apnea patients in the hospital’s post-anesthesia care unit.

“Patients undergo complex surgeries that require post-operative pain control,” Dr. Leah Baron, the chair of Virtua’s department of anesthesiology, said in an interview. “Although multi-modal pain management lately has gained wide acceptance, opioids remain the cornerstone of postoperative pain management for many of the surgical procedures. The pain relief is not without potential problems. Opioids have several undesirable side effects, including respiratory depression.”

Because of said potential respiratory problems, these patients are particularly important to monitor. But that’s where the alarm fatigue comes in.

“The technology that’s supposed to be helping the nurses’ workflow is actually distracting them from observing their patients directly,” Jeanne Venella, CNO of Milford, Connecticut-based Bernoulli Health, said in a phone interview.

John Zaleski, Bernoulli’s chief analytics officer, echoed those thoughts. “Particularly in units that aren’t equipped to manage alerts, you can quickly inundate the care staff with a lot of noise,” he said during a phone interview. “These can translate into noises that are not necessarily clinically actionable.”

Baron, Venella and Zaleski are coauthors of the study.

To mitigate these problems, Virtua teamed up with Bernoulli Health and implemented its Respiratory Depression Safety Surveillance system, which served as an alarm filter or “smart alarm” of sorts. It filtered out data from multiple medical devices and pinpointed clinically actionable events. On top of that, the study found that it reduced the overall number of alarms by 98 percent — without putting patients’ safety at risk.

“Smart alarms take out the noise and make us aware of the value,” Venella said. Rather than overwhelming clinical staff with a high frequency of alarms, the technology turns off the unnecessary notifications and heightens nurses’ awareness to when there’s actually a problem.

Through the study, Virtua learned about the value of education and cross-departmental support.

But it’s still a developing area.

“We learned a lot from this study,” Baron said. “A lot still needs to be done in this field. With this exciting technology, we are a step closer to being able to bring safer care to our patients and a better work environment to nurses and physicians caring for these complex patients.”

Photo: nevarpp, Getty Images

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