Author Biographical Info

Mary Isabel Alejo is an Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) student and Doctor of Nursing Practice (DNP) candidate with nine years of experience in cardiac critical care. She earned her Bachelor of Science in Nursing and currently holds specialized certifications including CCRN, ACLS, and BLS. Throughout her career, Mary has cultivated deep expertise in managing high-acuity patients and delivering safe, evidence-based care within complex and rapidly evolving clinical environments.

As a first-generation Houston native, she is committed to advancing the quality of care for diverse adult populations and contributing to system-level improvements grounded in clinical evidence. Her scholarly interests focus on optimizing patient safety, interprofessional collaboration, and clinical reliability. Mary’s DNP project centers on improving clinical alarm management through the implementation of an alarm management bundle, aiming to reduce alarm fatigue and enhance patient outcomes. She continues to pursue excellence through lifelong learning, leadership, and the advancement of evidence-driven practice in acute and critical care.

Date of Doctor of Nursing Practice Project Completion

Spring 4-15-2024

Faculty Advisor

Susan Ruppert

Abstract

The purpose is to increase nurses' perception toward clinical alarm management by implementing an alarm management bundle and educational skills in a Cardiovascular Intensive Care Unit (CVICU). The project was implemented in a 31- bed CVICU at a teaching facility in the Texas Medical Center. The Plan-Do-Study-Act was the chosen quality improvement model for the DNP project. Paper-based surveys were used to assess baseline data on competency and confidence levels of alarm management on the Philips monitor with the Healthcare Technology Foundation (HTF) Survey and the Nurse Competence on Philips Physiologic Monitors Use Survey. Active rounds were conducted to ensure compliance to C.E.A.S.E. (Communication, Electrode, Appropriateness, Set-Up, Education) alarm management bundle. Survey collection was completed by the project manager and securely stored. Competency levels were increased after the implementation of the evidence-based alarm management bundle. Skill sessions were effective in improving confidence levels on functionality of the Philips Physiologic monitor. Specifically changing alarm limits safely, differentiating alarms and patient-specific alarm customization were the focus of the bundle. Alarm perception resulted in: decreased in nuisance alarms, decreased disruption of care and decreased distrust in alarms. The project interventions were found to be influential to nursing practice. Standardization of the C.E.A.S.E. alarm management bundle is encouraged. Adoption of skill sessions and alarm management bundle into new-employee and refresher training education for the unit is supported.

Keywords

critical care, alarm management bundle, cardiovascular intensive care unit, clinical alarm management, alarm management competency

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