Current “normal” ranges for when an alarm should sound are based on somewhat arbitrary measurements, according to the paper. They are usually made using physicians’ consensus opinions or measurements from small groups of healthy children, rather than being based on a specific patient’s physiology. The team from Packard Children’s used 16 months worth of heart- and breathing-rate data in the system’s EHR to determine the high and low end range for alarms to sound.
In comparing these numbers to the National Institutes of Health-recommended ranges and other recent research, they found the current heart-rate reference range was slower, and the breathing reference range was narrower, than would be applicable to their patients, triggering significantly more alerts than is necessary. After running their data against a year’s worth of actual patient emergencies, the authors determined their newly calculated ranges were safe to implement.
“Data-driven vital alarm sign limits have the potential to decrease false monitor alarms, alarm-generated noise and alarm fatigue,” they concluded in the paper. “Ultimately, using a patient’s own physiologic data to define highly personalized vital sign parameter limits represents a truly precision approach, and could revolutionize the way hospitalized patients are monitored.”
More articles on alarm fatigue:
Acoustics researchers work to improve ineffective hospital alarms
EHR opioid warning system may trigger alarm fatigue, study finds
The deadline for alarm management was January 2016. Why are so many hospitals still not prepared?