According to Gallup, “trust” is frequently associated with nurses. It is comforting to know that patients delegate their safety to us. Many of you know how I feel about the ethical, legal and social contract that nurses have with the patients and families we serve. Vendor companies also share the responsibility – if it serves nurses, it indirectly serves patients, enough said!
Clinicians are often reluctant to make alarm configuration decisions – and I understand why. In clinical settings, nurses’ training and experience guide their patient care decisions. But when it comes to technology, nurses need support to translate alarm settings into patient safety. Ironically, effective alarm configurations start with clearly defined clinical guidelines and practices; that is what nurses know best! Such a deal! We just need to start there.
Monitor settings shouldn’t change, regardless of whether they are integrated with a mobile communication device, EHR or other technology. They should be based upon the needs of the patient, and the implications for clinical care. We must capture the appropriate “suspend” situations or delays that we currently use with audible alarms. If you were to monitor current behaviors you might discover that typical monitor default settings are actually quite flexible, and you use your clinical judgment, ignoring many alarm events.
Why are we trying to electronically send every alarm to a device? Just because we have one?
Trust your clinical judgment, “huddle” with the team, create the correct settings and policies, and when everyone agrees … call the technology team! Don’t assume that the first round of monitor settings will be ideal. Use a test environment to track the number and nature of alarms received. Are you capturing the critical incidents, while minimizing alarm fatigue? (Those nuisance alarms make us crazy!)