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Optimisation of clinical workflow and monitor settings safely reduces alarms in the NICU
Author(s) -
Varisco Gabriele,
Mortel Heidi,
CabreraQuiros Laura,
Atallah Louis,
HueskeKraus Dirk,
Long Xi,
Cottaar Eduardus JE,
Zhan Zhuozhao,
Andriessen Peter,
Pul Carola
Publication year - 2021
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.15615
Subject(s) - alarm , medicine , workflow , medical emergency , neonatal intensive care unit , oxygen saturation , emergency medicine , computer science , pediatrics , database , chemistry , materials science , organic chemistry , oxygen , composite material
Aim To address alarm fatigue, a new alarm management system which ensures a quicker delivery of alarms together with waveform information on nurses' handheld devices was implemented and settings optimised. The effects of this clinical implementation on alarm rates and nurses' responsiveness were measured in an 18‐bed single family rooms neonatal intensive care unit (NICU). Methods The technical implementation of the alarm management system was followed by clinical workflow optimisation. Alarms and vital parameters from October 2017 to December 2019 were analysed. Measures included monitoring alarms, nurses' response to alarms and time spent by patients in different saturation ranges. A survey among nurses was performed to evaluate changes in alarm rate and use of protocols. Results A significant reduction of monitoring alarms per patient days was detected after the optimisation phase (in particular for SpO2 ≤ 80%, P < .001). More time was spent by infants within the optimal peripheral oxygen saturation range (88% < SpO2 < 95%, P < .001). Results from the surveys showed that false alarms are less likely to cause an inappropriate response after the optimisation phase. Conclusion The implementation of an alarm management solution and an optimisation programme can safely reduce the alarm burden inside of the NICU environment.