‘Alarm Fatigue’ May Pose Risk For Patients

Hospital intensive care units have a lot going on in them.  You can hear the many different sounds, ventilators honking, infusion pumps make high pitch beeps, and blood pressure monitors make long tones.  But this equipment has an important function in scanning for changes in the patients’ heart rhythm, blood pressure, and other vital signs.

However, most of these noises are false alarms and do not require attention.  Such false alarms include the ventilator beeping because a patient coughs, the infusion pump beeping because the patient has run out of medication they no longer need, or the blood pressure monitor goes off when a nurse adjusts the catheter in a patient’s artery.

This huge number of alarms can cause what is called ‘alarm fatigue.’  When nurses or other workers become overwhelmed or desensitized from hearing the many different sounds all the time, they may end up turning the volume of the devices down, shut them off, or just ignore them.  However, these actions can have fatal consequences.

Clinicians and patient-safety advocates have been warning of this issue for years, but now there is more urgency to change things since hospitals are investing in more complex and often noisy devices that are meant to save lives.  Accredited hospitals have been directed by the Joint Commission to make alarm safety a priority, or they risk losing their accreditation.

There have been 98 reports of alarm related incidents in the 3 1/2 years (which ended June 2012).  In 60 percent of these cases, the alarms had either been inappropriately turned off or were not audible in all areas.  The Joint Commission says that these voluntary reports were just a small number of the actual number of incidents.  It was estimated that close to 1,000 alarm incidents occurred in which the patient died, was injured, or faced those risks.  Some hospitals are now being required to identify which alarms pose the biggest safety risk when they add unnecessary noise or being ignored.  Hospitals also need to determine who has the authority to turn off alarms by 2016.

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