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Combatting clinical alarm fatigue

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According to Sendelbach and Funk , Alarm fatigue is sensory overload when clinicians are exposed to an excessive number of alarms, which can result in desensitisation to alarms and missed alarms.

Healthcare professionals (HCPs) can be exposed to as many as 1000 alarms per shift and 72% to 99% of these alarms will be false1 or non-actionable, in clinical status of a patient, but no intervention is required.

For healthcare providers and HCPs, this can cause significant issues as there is a direct correlation between alarm fatigue and patient safety - so much so, ‘Alarm, alert and notification overload’ regularly appeared in the ECRI’s Top 10 health technology-related hazards up until 2020; only superseded in 2021 by Covid-19 related hazards.  

Technology communicates with us daily and when we talk about ‘alarms’ or ‘notifications’, these can range from vital sign abnormality warnings to task- or action-based email reminders.

With a sharp rise in both clinical and administrative technology within healthcare organisations, and an increased use of machine learning and artificially intelligent software, there is an even greater risk of alarm fatigue; fatigue, and therefore a greater patient safety issue looming.

We need to change this risk trajectory. So, do we turn off all the alarms? No, that would be a little extreme. But to support a more effective alarm response, we do need a better insight into organisational and individual behaviour and attitudes when building alarm and notification systems.

We know that alarms are most effective when contextual. We wouldn’t circulate an email notification in the event of a fire, as the resulting action of a prompt evacuation wouldn’t be followed quickly enough - so a loud sound to instigate an evacuation procedure is most suitable in this instance. It is therefore nonsensical that actionable alarms and notifications in a healthcare setting should be delivered in the same way as non-actionable alarms and notifications.

When we built Credentially, we spent a lot of time understanding how notifications could be configured to deliver increased efficiencies, including flagging non-compliant records or forthcoming expiry dates to avoid carrying out manual checks.

Mindful of how these notifications could contribute to alarm fatigue, our software includes automated fail-safes, workflows and feedback loops that can also be passed to other systems if required. This automated response to actionable alarms ensures nothing gets missed, regardless of whether a specific notification has been viewed by a human.

As a healthcare software provider, we have an inherent responsibility to address the patient safety agenda – which does not always need to be driven by humans. Technology has a significant role to play in improving patient safety, and demonstrable quality improvement in this area should be a key factor in the software selection process for any function in a healthcare organisation.

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