Alarm fatigue can be especially dangerous in hospitals. The constant ringing can quickly becoming so much a part of the environment that the sounds don't trigger much of a response from healthcare professionals, and the persistent disruption can impact patient sleep, wellness and recovery. A new study from the Lucile Packard Children's Hospital Stanford (Calif.) suggests one fix — tailoring alerts to the physiological limits of individual patients — could make a big difference in the fight against alarm fatigue.
Current "normal" ranges for when an alarm should sound are based on somewhat arbitrary measurements, according to the paper. They are usually made using physicians' consensus opinions or measurements from small groups of healthy children, rather than being based on a specific patient's physiology. The team from Packard Children's used 16 months worth of heart- and breathing-rate data in the system's EHR to determine the high and low end range for alarms to sound.
In comparing these numbers to the National Institutes of Health-recommended ranges and other recent research, they found the current heart-rate reference range was slower, and the breathing reference range was narrower, than would be applicable to their patients, triggering significantly more alerts than is necessary. After running their data against a year's worth of actual patient emergencies, the authors determined their newly calculated ranges were safe to implement.
"Data-driven vital alarm sign limits have the potential to decrease false monitor alarms, alarm-generated noise and alarm fatigue," they concluded in the paper. "Ultimately, using a patient's own physiologic data to define highly personalized vital sign parameter limits represents a truly precision approach, and could revolutionize the way hospitalized patients are monitored."