alarms - Critical Care Management AN CCE PE HCSP ATIONAL...

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By Denise M. Korniewicz, RN, PhD, Tobey Clark, MS, CCE, and Yadin David, EdD, CCE, PE, HCSP Purpose To develop a national online survey to be adminis- tered by the American College of Clinical Engineers Healthcare Technology Foundation to hospitals and healthcare workers to determine the problems associated with alarms in hospitals. Methods An online survey was developed by a 16-member task force representing professionals from clinical engineer- ing, nursing, and technology to evaluate the reasons health- care workers do not respond to clinical alarms. Results A total of 1327 persons responded to the survey; most (94%) worked in acute care hospitals. About half of the respondents were registered nurses (51%), and one-third of respondents (31%) worked in a critical care unit. Most respondents (>90%) agreed or strongly agreed with the state- ments covering the purpose of clinical alarms and the need for prioritized and easily differentiated audible and visual alarms. Likewise, many respondents identified nuisance alarms as problematic; most agreed or strongly agreed that the alarms occur frequently (81%), disrupt patient care (77%), and can reduce trust in alarms and cause caregivers to dis- able them (78%). Conclusions Effective clinical alarm management relies on (1) equipment designs that promote appropriate use, (2) cli- nicians who take an active role in learning how to use equip- ment safely over its full range of capabilities, and (3) hospitals that recognize the complexities of managing clinical alarms and devote the necessary resources to develop effective management schemes. ( American Journal of Critical Care. 2008;17:36-43) 36 AJCC AMERICAN JOURNAL OF CRITICAL CARE, January 2008, Volume 17, No. 1 A N ATIONAL O NLINE S URVEY ON THE E FFECTIVENESS OF C LINICAL A LARMS C ritical Care Management This article is followed by an AJCC Patient Care Page on page 44. E R B Evidence-Based Review on pp 42-43.
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Although many organizations focus on appro- priate deployment of technology at the bedside, it was the Joint Commission on Accreditation of Health Care Organizations (JCAHO) 1 that reviewed 23 reports of death or injury related to mechanical ven- tilation. Of the 23 events, 19 resulted in death and 4 resulted in coma; 65% were related to alarms. 2 As a result, the JCAHO set 6 national patient safety goals for 2003, 1 one of which was to improve the overall effectiveness of clinical alarms. This goal remained as a national patient safety goal for 2004; after 2004 it was removed from the list and became part of the JCAHO accreditation requirements. Despite the change in status for the JCAHO patient safety goal for clinical alarms, the frequent alarm-related adverse events reported to the Food and Drug Administration and the Emergency Care Research Institute (ECRI) illustrate that management of clinical alarms still requires attention from health- care workers and hospital administrators. Healthcare workers report that frequent false alarms are a nui-
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alarms - Critical Care Management AN CCE PE HCSP ATIONAL...

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