Development of the InitiativeToday’s alarm indicators go beyond the traditional audible and visual alerts at the bedside and nursing stations. New developments include alarm integration systems which combine alarms from various sources and intelligently manage and deliver messaging to clinicians via pagers, nurse call systems, dashboards, tactile devices or cell phones. As diagnostics move to the patient at the point-of-care, these alerts will not only include alarms from the physiological monitors, but may contain critical diagnostic results from the clinical laboratory, pathology, and imaging. Much work has been done related to smart alarms which use advanced signal processing of physiological data. In the care management area, best practices have been published in many clinical journals.
Despite the inclusion of Patient Safety Goal #6 - Clinical Alarms Improvement - in the JCAHO hospital accreditation standards from 2002-2004, alarm-related incidents and events continue to occur due to a variety causes. For example, deaths and injuries reported to the FDA with the term "alarm" in the description increased from 189 in 2000 to 449 in 2004. Healthcare provider shortages combined with the exponential growth of technology and systems increase the importance of continuing to improve alarm systems. Alarm shortcomings typically fall into the catagories of system design, system performance, care management, and environmental influences.
The ACCE Healthcare Technology Foundation (ACCE-HTF) in conjunction with a number of national healthcare organizations has put forth an initiative to:
- To improve patient safety by identifying issues and opportunities for enhancements in clinical alarm design, operation, response, communication, and appropriate actions to resolve alarm-related events.
Activities undertaken by this multi-disciplinary task force include open forums, audio conferences, development of educational materials, literature and hazard reviews, the development and implementation of a clinical alarms survey, and the publication of a "White Paper" on clinical alarms.