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Nurses Explain Risk of “Alarm Fatigue” in Hospitals

A Boston News story this weekend commented on unique concern among patient safety experts that provides a counterintuitive argument about monitoring patient well being in hospitals. Some medical professionals are noting that the increased use of certain heart rate monitoring may actually lead to more errors in the monitoring process. As any Illinois medical malpractice lawyer will know, monitoring the condition of patients appropriately, and providing necessary care based on that monitoring information, is a part of all prudent medical caregiving. Failure in this regard may be medical malpractice.

In the past, cardiac monitors-machines that provide constant measurement of heart rate and other variables of patients-were used only on the most seriously injured or ill. However, as technology has improved and access to these monitors has increased, many facilities are using much more advanced monitoring procedures. Many hospitals now have “war rooms’ where all monitors are tracked in one place. In other hospitals every bedside in the facility includes a monitor. This trend toward increased use of monitoring seems a logical step in improving patient care. After all, it is imperative that medical professionals correctively identify patient problems at the soonest possible time. Monitors help them do that as efficiently as possible. Also, the monitoring is noninvasive, proving little patient discomfort. Another selling point of the monitors for some hospitals administrators is that they are cost effective. They often allow sicker patients to be cared for on regular floors, ultimately lowering the overall need for nurses in intensive care units.

However, there are some who are voicing concern about the overall effect that this monitoring trend is having on patient safety.

Many experts, including many nurses, have noted that the expanded use of these machines is leading to a problem called “Alarm Fatigue.” In essence, the fatigue refers to the fact that those who monitor the machines can become overwhelmed, often missing important information that is provided by them. Each machine comes loaded with measuring alarms that provide a constant stream of beeps and buzzes. Considering that so many patients are now monitored, a nurse supervising a “war room” of monitors will be inundated with the beeping of the devices. Over time the nurse becomes desensitized to the sounds, and may miss important warnings. A study published by The Globe recently identified dozens of death that have been attributed to this fatigue.

At the root of the fatigue problem is the fact that majority of alarms coming from these monitors are caused by things like a patient coughing or moving around in bed. Alarms from these sorts of actions have been found to trigger at least 80% of alarms. By the end of the day, these alarms often become white noise. They are ignored. Of course, what the means is that some of those alarms a patient who is actually in trouble may also be ignored. It does not take a medical malpractice lawyer to explain that it is unacceptable for medical caregivers not to act upon information from a monitor that should have been acted upon quickly.

One researcher explained that “a lot of people who are on monitors are on them for justifiable reasons.” However she noted that for others they are used “as a kind of babysitter.” It is that babysitter approach which leads to more false alarms and alarm fatigue. Potentially deadly medical malpractice often results.

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