Clinical Alarms Management and Integration
In 2004, Healthcare Technology Foundation started an initiative to improve clinical alarms in healthcare. The initial milestone was the completion of a white paper – Impact of Clinical Alarms on Patient Safety in 2007. This paper reviews the literature related to clinical alarm factors and analyzes adverse event databases. Efforts to improve alarms through technological, standards, and regulatory means are assessed and evaluated. Forums, meetings and a survey of 1,327 clinicians, engineers, technical staff and managers provided considerable feedback regarding alarm issues. This paper would not be possible without the contributions of a Task Force of clinical engineers, academic professionals, and consultants.
Observations and recommendations have been developed to improve the impact of clinical alarms on patient safety. Significant findings consisted of 1) recommendations to the medical device industry to greatly improve parameter acquisition accuracy, use "smart" alarm technology, and intelligent alarm systems including appropriate tie-in to IHE, and 2) recommendations to consider ISO/IEC 60601-1-8 alarm standards. From a patient care perspective, clear outcomes of the study included a strong clinical response showing false alarms to be the most significant issue, along with the need to manage alarms through prioritization, training and work processes assessment. Future directions are aimed at awareness, a focused effort towards the reduction of false alarms, and soliciting all constituents involved in clinical alarms to meet and develop action plans to address key issues.
In 2011, a re-survey of the field resulted in an overwhelming national response. The Healthcare Technology Foundation’s survey 2011 National Clinical Alarms Survey resulted in 4278 responders – 93% clinical staff – voicing their perceptions, issues, improvements and priorities about this highly visible, complex patient safety concern. The overall results and recommendations were distributed to the 298 attendees at the AAMI Medical Device Alarms Summit where the Healthcare Technology Foundation was a supporting organization.
2011 National Clinical Alarms Survey (2.7Mb)
2007 National Patient Safety Foundation Clinical Alarms Poster (144 Kb)
2007 National Patient Safety Foundation Clinical Alarms Poster Abstract (32 Kb)
2006 Clinical Alarms White Paper Power Point (566 Kb)
2007 Impact of Clinical Alarms on Patient Safety, Journal of Clinical Engineering, January/March (1.1 Mb)
2006 Impact of Clinical Alarms on Patient Safety (410 Kb)
2006 Alarm Call for Action – What You Can Do (135 Kb)
2005-2006 Presentations and publications
2004-2007 Task force members
2005 Organizations Contributing to the Survey Design and/or Distribution
2005 Bibliography
2004 Development of the Initiative
2012 National Clinical Alarms Surveys – 5 years Comparison of Issues, Improvements and Priorities, WC2012/IFMBE Proceedings Paper, May (294 Kb)
2012 Alarm Fatigue, Cuidado, January (133 Kb)
2010 Closing the Clinical Alarm Gap, 24x7, September
2008 Fault Tree Analysis of Clinical Alarms, Journal of Clinical Engineering, April/June (441 Kb)
2008 Alarms and Nurse to Patient Ratios, American Journal of Critical Care, March (58 Kb)
2008 National Online Survey on the Effectiveness of Clinical Alarms, American Journal of Critical Care, January
2012 AAMI Foundation Healthcare Technology Safety Institute – Clinical Alarms
Alarm Safety Resource Site, ECRI Institute
2011 Alarming Monitor Problems, January, US FDA
2011 Alarming Monitor Problems, Video-January, US FDA
2012 What's That Sound I Hear?, AARC (link to AARC Website) (831 Kb)
2012 ECRI Institute Top 10 Health Technology Hazards
2012 FDA Working to Trim Hospital "Alarm Fatigue" Boston Globe, March 24
2012 Did You Hear an Alarm?, Massachusetts Board of Registration in Medicine, March
2011 JAMA Tele-ICU article, JAMA, June (214 Kb) (subscription required)
2011 The Need for Systems Integration In Health Care, JAMA, March (46 Kb) (subscription required)
2011 Reducing Alarm Hazards, Patient Safety & Quality Healthcare
2010 Auditory Assistance-Strategies to reduce hospital noise problems
2008 Fixing an Alarming Situation, Health Data Management (362 Kb)
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