A multidisciplinary approach to reducing alarm fatigue and cost through appropriate use of cardiac telemetry.
Postgrad Med J
; 93(1101): 430-435, 2017 Jul.
Article
em En
| MEDLINE
| ID: mdl-28455284
ABSTRACT
BACKGROUND:
Alarm fatigue (AF) is a distressing factor for staff and patients in the hospital. Using cardiac telemetry (CT) without clinical indications can create unnecessary alarms, and increase AF and cost of healthcare. We sought to reduce AF and cost associated with CT monitoring.METHODS:
After implementing a new protocol for CT placement, data were collected on telemetry orders, alarms and bed cost for 13 weeks from 1 January 2015 through 31 March 2015. We also retrospectively collected data on the same variables for the 13 weeks prior to the intervention. A survey was administered to nurses to assess past and present perceptions of AF. Interventions included protocol creation and education for participants.RESULTS:
At baseline, 77% of patients were monitored with CT. A total of 145 (31%) order discrepancies were discovered during data collection, of which 72% had no indication for CT, so CT was discontinued. The other 28% had indications, so orders were placed. A total of 8336 alarms were recorded during 4 weeks of data collection, of which 333 (4%) were classified as true actionable alarms. Postintervention data showed 67% CT assignment with 10% reduction in CT usage, with no increase in mortality (p<0.001 and >0.05, respectively). A 42% cost reduction was achieved after adjusting the patient status. Nurses reported 27% perceived reduction in AF. One-year follow-up revealed that 69% of patients were being monitored by CT, and the rate of order discrepancies due to lack of indication was 9%.CONCLUSION:
All hospital units may benefit from the protocols created during this study. If applied appropriately, these protocols can lead to reduced AF and cost per episode of care.Palavras-chave
Texto completo:
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Bases de dados:
MEDLINE
Assunto principal:
Telemetria
/
Esgotamento Profissional
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Cardiologia
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Fadiga
/
Alarmes Clínicos
/
Melhoria de Qualidade
Tipo de estudo:
Guideline
/
Health_economic_evaluation
/
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Postgrad Med J
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Estados Unidos