Reducing Alert Fatigue for Comfort Care and Palliative Care Hospital Patients

Abstract

Hospital nurses are inundated by numerous non-actionable and false telemetry alarms from bedside monitors, central nursing stations, and, in some cases, also from alarms escalated to hospital-provided cellphones after a short time period. There is widespread that patients electing to have DNR/comfort care status do not require telemetry monitoring, and an increasing awareness of the interference of these alarms with valuable end-of-life conversations and interactions with family members. In this project, we instituted policy changes, changes to the electronic health record, and educational interventions for physicians and nurses in order to reduce the proportion of DNR-CC patients with active telemetry monitoring. Overall, we learned that many bedside nurses prefer to turn down the volume or turn off the display inside rooms, which addresses the interference with family interactions but does not reduce the volume of unnecessary alarms and associated documentation requirements and inclusion of alarms in population-based analyses.