Date of Doctor of Nursing Practice Project Completion

Summer 8-10-2026

Faculty Advisor

LaDawna Goering, DNP, APRN, ANP-BC, BC-ADM, CDP

Abstract

Purpose: This quality improvement (QI) project aimed to reduce alarm fatigue by implementing an alarm fatigue bundle protocol in an Intermediate Medical Unit (IMU) at a mall public hospital in Houston, Texas. The project aimed to achieve 80% compliance with daily electrode changes, improve alarm response times by 10%, reduce telemetry technician calls by 15%, and reduce alarm fatigue levels by 20%.

Background: Frequent non-actionable alarms can lead to desensitization, delayed responses, and missed alarms.

Methodology: The Plan-Do-Study-Act (PDSA) Model guided implementation of the CEASE bundle, focusing on staff education and daily electrode changes. Daily audits assessed skin preparation and electrode change compliance, while telemetry technicians documented reasons for calls. The Charité Alarm Fatigue Questionnaire (CAFQ) measured alarm fatigue pre- and post-intervention. Call light and bed alarm response times were obtained from Responder 5 reports. Feedback from stakeholders helped drive revisions to the project throughout PDSA cycles.

Results: Mean CAFQ scores decreased by 10.5% but did not meet the goal. Bed alarm and call light response times improved by 18.1% and 17.1%, both exceeding the 10% goal. Weekly electrode change compliance ranged from 31% to 75% and did not meet the goal. Incomplete telemetry documentation prevented evaluation of the reduction goal.

Implications: Limitations included inconsistent intervention compliance, low CAFQ participation, and incomplete telemetry documentation. Continued leadership support, staff education, and audits are recommended to improve compliance, sustain changes, and support adoption of an alarm fatigue bundle in other inpatient settings.

Keywords: alarm fatigue, CEASE bundle, telemetry

Keywords

Alarm fatigue, CEASE bundle, Telemetry

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