Clinical

Reducing alarm fatigue

Monitoring from a centralized location


 

Hospitalists hearing the constant noise from cardiac telemetry monitoring systems can experience alarm fatigue – a nationwide phenomenon that can lead to an increase in patient deaths.

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The American Heart Association reports that fewer than one in four adults survived an in-hospital cardiac arrest in 2013; other studies showed that up to 44% of inpatient cardiac arrests were not detected appropriately, according to the Cleveland Clinic.

Clinicians at the Cleveland Clinic have tried centralized monitoring to address the problem. They’ve established a “mission control” center, where off-site personnel monitor sensors and high-definition cameras and vital signs such as blood pressure, heart rate, and respiration. On-site action is requested when appropriate; unimportant alarms are dismissed.

In August 2016, results from the first 13 months of the Cleveland Clinic program were published in JAMA. They revealed that the monitoring system could help reduce rates of unimportant alarms with no increase in cardiopulmonary arrest events. The centralized unit monitored 99,048 patient orders, and ultimately detected serious problems and accurately notified on-site staff for 79% of 3,243 events, which included a rhythm and/or rate change within 1 hour or less of the event. Accurate notification to on-site hospital staff was more than 84%.

Since then, improvements to the system have continued, according to Cleveland Clinic, and include doubling the number of monitored patients per technician and improved clinical outcomes.

Reference

Cleveland Clinic: Consult QD – An update on the centralized cardiac telemetry monitoring unit

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