What happened to summer being a time to slow down and relax? For many of us, especially those who are parents of young children, summer brings with it an exhausting schedule filled with camps, sports, vacations and activities. In addition to spending time with my wife and kids, I recently signed up with Best Buddies International and began mentoring a 30-year-old man with intellectual and developmental disabilities. Their goal is to end the social, physical and economic isolation that many people with disabilities experience every day. So my new buddy and I do stuff together that friends do: go out to dinner, go to the movies, work out at the gym, and enjoy time with my family on the boat.
On top of all that is my busy work schedule, which includes traveling to hospitals throughout the country. When I shadow nurses for a day, observing how they work and analyzing the ways they manage alarm and alert notifications while caring for patients, I realize my hectic schedule is a breeze compared to theirs. While I can definitely relate to feeling “fatigue,” I can’t imagine how a busy nurse feels when he or she is bombarded on every shift with dozens of interruptions from multiple medical devices, nurse call systems and various manual methods of communication (including yells down the hall).
And it’s not only nurses and other caregivers who suffer. The Joint Commission’s National Patient Safety Goal aims to improve the safety of clinical alarm systems by recognizing the danger of “alarm fatigue” and the detrimental effect it can have on patients:
“Many patient care areas have numerous alarm signals, and the resulting noise and displayed information tends to desensitize staff and cause them to miss or ignore alarm signals or even disable them. Other issues associated with effective clinical alarm system management include too many devices with alarms, default settings that are not at an actionable level, and alarm limits that are too narrow.”
We all know how difficult it is to do our best work when we’re feeling tired and overwhelmed. So we can imagine how hard it is for nurses to provide excellent patient care when they are inundated with a multitude of beeps and buzzes. Oftentimes, deploying smartphones for caregiver communication appears to exacerbate this problem, because as a secondary “endpoint” device, the smartphone is used to display these notifications.
There is a big difference between “alarm fatigue” and “alert fatigue,” yet many people lump the two together. “Alarm fatigue” happens at the medical device level, so hospitals need to start there to come up with solutions. Medical devices alarm too often when alarm parameters are not set properly based on patient demographics. If a hospital doesn’t address this problem first, before deploying middleware and routing those alarm notifications to smartphones, then “alert fatigue” is the result. When medical devices are alarming too often with non-actionable information, sending those alerts to nurses can create chaos. Without well-planned clinical workflows, the smartphone can become a burden rather than a helpful tool. Fortunately, many of our customers are focusing on this challenge and making it a priority to come up with solutions.
Akron Children’s Hospital is a great example. They took a proactive approach by forming an alarm management committee to study the issue of alarm fatigue in their Neonatal Intensive Care Unit (NICU). The team collected monthly census numbers and reports from the Connexall middleware by alarm type. Based on the results, they identified when they could safely increase the time between the alarm trigger and when it was sent to the Voalte smartphone, ultimately resulting in a 57 percent reduction in those alarms with no change in patient outcomes. Even better, the NICU nurses appreciated the attention the hospital gave to the issue of alarm management and reducing fatigue. (Read the case study for more details.)
I think many of us can relate to feeling fatigued. This summer, I plan to focus on the actionable events in my life that create joy and reduce stress – I hope you can do the same.
Eric Brill is General Manager of Clinical Solutions at Voalte.