NICU hyperoxia alarms may cause alarm fatigue and negatively impact patient safety

Oxygen saturation alarms are a vital patient care tool to alert medical workers of possible hyperoxia, but too many alarms can cause alarm fatigue for workers and negatively patient safety, according to a study published in the journal Pediatrics.

A study conducted in a neonatal intensive care unit at C.S. Mott Children's Hospital in Ann Arbor, Mich., helped create an alarm management bundle to decrease alarm frequency. To create the bundle, researchers examined existing alarm strategies and developed patient care-based and systems-based interventions.

The team of researchers also assessed the total number of delivered and detected saturation alarms and high saturation alarms, the total time spent within a targeted saturation range and nursing morale.

The results of the study showed:

1. High pulse oxygen saturation, or SpO2, alarms per monitored patient day increased from 78 to 105 after the narrowing of alarm limits.

2. Modification of the high saturation alarm algorithm substantially decreased the delivery and escalation of SpO2 alarms.

3. During a pilot period, using histogram technology to individually customize alarm limits resulted in increased time spent within the targeted saturation range and fewer alarms per day.

4. Qualitatively, nurses reported improved satisfaction when they were not assigned more than one infant with frequent alarms, as identified by an alarm frequency tool.

"Alarm fatigue may detrimentally affect patient care and safety. Alarm management strategies should coincide with oxygen management within a NICU, especially in single-patient-bed units," concluded the study authors.



More articles on alarm fatigue:
Spok: Avoiding alarm fatigue essential to patient care
How Abbott Northwestern is reducing alarm fatigue to enhance patient safety
Silence the crying wolf: How to reduce hospital alarm fatigue

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