Abstract
BackgroundInformed estimates claim that 80% to 99% of alarms set off in hospital units are false or clinically insignificant, representing a cacophony of sounds that do not present a real danger to patients. These false alarms can lead to an alert overload that causes a health care provider to miss important events that could be harmful or even life-threatening. As health care units become more dependent on monitoring devices for patient care purposes, the alarm fatigue issue has to be addressed as a major concern for the health care team as well as to enhance patient safety.ObjectiveThe main goal of this paper was to propose a feasible solution for the alarm fatigue problem by using an automatic reasoning mechanism to decide how to notify members of the health care team. The aim was to reduce the number of notifications sent by determining whether or not to group a set of alarms that occur over a short period of time to deliver them together, without compromising patient safety.MethodsThis paper describes: (1) a model for supporting reasoning algorithms that decide how to notify caregivers to avoid alarm fatigue; (2) an architecture for health systems that support patient monitoring and notification capabilities; and (3) a reasoning algorithm that specifies how to notify caregivers by deciding whether to aggregate a group of alarms to avoid alarm fatigue.ResultsExperiments were used to demonstrate that providing a reasoning system can reduce the notifications received by the caregivers by up to 99.3% (582/586) of the total alarms generated. Our experiments were evaluated through the use of a dataset comprising patient monitoring data and vital signs recorded during 32 surgical cases where patients underwent anesthesia at the Royal Adelaide Hospital. We present the results of our algorithm by using graphs we generated using the R language, where we show whether the algorithm decided to deliver an alarm immediately or after a delay.ConclusionsThe experimental results strongly suggest that this reasoning algorithm is a useful strategy for avoiding alarm fatigue. Although we evaluated our algorithm in an experimental environment, we tried to reproduce the context of a clinical environment by using real-world patient data. Our future work is to reproduce the evaluation study based on more realistic clinical conditions by increasing the number of patients, monitoring parameters, and types of alarm.
Highlights
Alarm FatigueInformation Technology (IT) has already provided significant benefits to the health care sector, but there are still many areas where the application of IT could offer further critical improvements
Our experiments were evaluated through the use of a dataset comprising patient monitoring data and vital signs recorded during 32 surgical cases where patients underwent anesthesia at the Royal Adelaide Hospital
We present the results of our algorithm by using graphs we generated using the R language, where we show whether the algorithm decided to deliver an alarm immediately or after a delay
Summary
Alarm FatigueInformation Technology (IT) has already provided significant benefits to the health care sector, but there are still many areas where the application of IT could offer further critical improvements. To illustrate the severity of this problem that has been treated as a major patient safety concern, scientific studies have reported that there was an average of 700 physiologic monitor alarms per patient per day [1] Such a number indicates a severe sensory overload for the health care staff, with serious consequences for the well-being of the patients when an alarm might be ignored. Informed estimates claim that 80% to 99% of alarms set off in hospital units are false or clinically insignificant, representing a cacophony of sounds that do not present a real danger to patients These false alarms can lead to an alert overload that causes a health care provider to miss important events that could be harmful or even life-threatening. As health care units become more dependent on monitoring devices for patient care purposes, the alarm fatigue issue has to be addressed as a major concern for the health care team as well as to enhance patient safety
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