Alarm Management

An estimated 85 percent to 991,2 percent of alarms in healthcare facilities don’t require clinical intervention. Because of this high percentage of insignificant alerts, clinicians can develop “alarm fatigue,” which can result in them tuning out these notifications and missing the alarms that truly signal a patient’s critical medical crisis.
 

Monitor alarms are designed to alert caregivers to changes in a patient’s condition and can save lives. However, as the number of alarms encountered by clinicians on a daily basis rises, it has become difficult for caregivers to distinguish between clinically significant alarms and nuisance alarms. As a result, alarm fatigue has become a serious issue, which puts patients at risk.
 

Covidien is a proud sponsor of the AAMI Foundation’s National Coalition for Alarm Management and Safety. Learn more
 

  1. Graham KC, Cvach M. Monitor alarm fatigue: standardizing use of physiological monitors and decreasing nuisance alarms. Am J Crit Care. 2010;19(1):28-35. [ View Abstract ]
  2. The Joint Commission. Medical device alarm safety in hospitals. Sentinel Event Alert. April 8, 2013; issue 50. Available at: http://www.jointcommission.org/assets/1/18/SEA_50_alarms_4_5_13_FINAL1.PDF. [ View Abstract ]

 

Alarm fatigue is an ever-present problem for healthcare providers. It was named the number one medical technology hazard in 2015 by the ECRI Institute1. Additionally, hospital-based clinical engineers and biomedical equipment technicians identified alarm management as one of their top medical device challenges in two separate surveys by AAMI. In April 2013, The Joint Commission addressed the issue in a Sentinel Event Alert (SEA) on Medical Device Alarm Safety in Hospitals2. The SEA was followed by a National Patient Safety Goal (NPSG) on Alarm Management issued in June 20133, which is effective in two phases:

  • In phase I, effective January 2014, hospitals were required to establish alarms as an organization priority and identify the most important alarms to manage based on their own internal situations.
  • In phase II, effective January 2016, hospitals will be expected to develop and implement specific components of policies and procedures. Education of those in the organization about alarm system management will also be required in January 2016.3

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2015 Top 10 Patient Safety Concerns for Healthcare Organizations:

ECRI Institute released its 2015 report on the Top 10 Patient Safety Concerns Confronting Healthcare Organizations. Click to view and download the report.

The Joint Commission: Medical device alarm safety in hospitals

The Joint Commission: Facts about the National Patient Safety Goals

 

  1. ECRI Institute. 2015 Top 10 Patient Safety Concerns for Healthcare Organizations, April 2015. https://www.ecri.org/Pages/Top-10-Patient-Safety-Concerns.aspx.
  2. The Joint Commission. Medical device alarm safety in hospitals. Sentinel Event Alert. April 8, 2013; issue 50. Available at:http://www.jointcommission.org/assets/1/18/SEA_50_alarms_4_5_13_FINAL1.PDF[ View Abstract ]
  3. The Joint Commission. Facts about the National Patient Safety Goals. National Patient Safety Goal on Alarm Management. June 25, 2013. Available at: https://www.jointcommission.org/facts_about_the_national_patient_safety_goals/.

 

 

Alarm Management Features for Pulse Oximetry Monitoring

Nellcor™ SatSeconds

SatSeconds analyzes desaturation events by multiplying their duration, in seconds, by the number of percentage points the patient drops below the SpO2 alarm limit. As a safety precaution, when three or more SpO2 alarm violations occur within 60 seconds, an alarm will sound even if the SatSeconds limit has not been reached.

Learn more ]
 

LoSat Expanded Accuracy

Nellcor™ adhesive sensors with OxiMax™ technology and LoSat Expanded Accuracy range give clinicians the ability to assess patients with critically low saturation readings (60%-80%), such as infants with congenital heart disease. Accurate readings at low saturation levels expand options for clinicians to effectively monitor pulse oximetry.3

Alarm Management Features for Capnography Monitoring

Apnea-Sat Alert (ASA)*

ASA tracks and reports apneas per hour (A/hr), and the oxygen desaturation index (ODI) indicates the ‘dips’ in SpO2 (number of times the SpO2 value dropped 4 percent or more from baseline and returned to baseline in 240 seconds or less). A visual alert appears if the A/hr exceed a preset threshold over user selectable time periods of 2, 4, 8 or 12 hours. A/hr and ODI are displayed in real time on the monitor home screen, and the data is available in trend reports, in print outs and through data export.

ASA trend screen displays an analysis of A/hr by length of the apneas.

*Apnea-Sat Alert is FDA cleared for adults 22 years of age or older.

Smart Breath Detection™ (SBD)

Proprietary filter and pattern recognition algorithm screens out low-amplitude “non-breath” etCO2excursions like snoring, talking or crying, to provide a more accurate respiratory rate.

Smart Alarm for Respiratory Analysis™ (SARA)

Reducing distractions from clinically insignificant alarms helps preserve caregiver alarm vigilance, leading to improved patient safety.1 Functioning in combination with the SBD algorithm, the SARA algorithm is proven to reduce clinically insignificant respiratory rate alarms by dynamically adjusting the respiratory rate averaging algorithm during periods of breath-to-breath cycle variability.2

Integrated Pulmonary Index™ (IPI)

IPI incorporates four real-time respiratory measurements into a single number, displayed on a scale from 1 to 10, representing an inclusive respiratory profile. Helpful in busy clinical environments, IPI provides a simple and comprehensive indication of respiratory status and trends, promoting early awareness of changes to a patient’s breathing.

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[Smart Alarm Management Integrated Algorithms]

[Smart Alarm for Respiratory Analysis™]

Remote Alarm Management Solutions

Covidien supports a range of remote alarm annunciation connectivity options to help clinicians monitor patients through nurse call systems, stand-alone central stations, wireless phones and pagers.
 

Vital Sync™ Virtual Patient Monitoring Platform (VPMP)

Vital Sync VPMP offers Electronic Medical Record (EMR) connectivity and remote continuous patient monitoring. Clinicians can remotely view patient information from ventilators, capnography monitors and pulse oximeters on any web-enabled devices. Patient information is sent to the EMR, Clinical Information System, and alarm forwarding systems.

 

Learn more ]

  1. The hazards of alarm overload. Keeping excessive physiologic monitoring alarms from impeding care. Health Devices. 2007;36(3):73-83. [ View Abstract ]
  2. Hockman S, Glembot T, Niebel K. Comparison of capnography derived respiratory rate alarm frequency using the SARA algorithm versus an established non-adaptive respiratory rate alarm management algorithm in bariatric surgical patients. [Open forum abstracts] Resp Care. 2009;12. [ View Abstract ]
  3. Bebout DE, Mannheimer PD, Wun C-C. Site-dependent differences in the time to detect changes in saturation during low perfusion.Crit Care Med. 2001;29(12):A115. [ View Abstract ]