Battling alarm fatigue in the intensive care unit by reducing unnecessary clinical alarms through daily electrode electrocardiogram (ECG) electrode changes

Date of Doctor of Nursing Practice Project Completion

2024

Faculty Advisor

Dr. Linda A. Roussel

Abstract

Purpose: The purpose of this scholarly project was to decrease the number of clinicals alarms in the intensive care unit (ICU) by conducting daily electrocardiogram (ECG) electrode changes to tackle the issue of alarm fatigue within the nurses in the ICU.

Background: The project was implemented in an 18-bed Surgical Intensive Care Unit (SICU) at an academic healthcare organization in Houston, Texas.

Methodology: .The plan-do-study-act cycle quality improvement methodological framework was employed to measure a small test of change during the implementation phase of ECG lead changes. Change in intervention was including date on ECG electrode. Alarm fatigue was assessed by a survey created in Qualtrics. Staff members in the SICU completed pre- and post-surveys after the improvement intervention was initiated. Audits to count the number of clinical alarms were conducted for seven days pre-intervention and post-intervention implementation

Results: Before intervention, there was a total of 303 ECG related clinical alarms. After initiating ECG electrode changes, there were a total of 259 clinical alarms. Post survey of alarm fatigue among ICU staff revealed reduced alarm fatigue. No adverse events were noted during this project.

Implications: Decreasing alarm fatigue within the intensive care units will assist with timely management of clinical alarms which will decrease the number of adverse events. Addressing the issue of alarm fatigue in ICU ensures that patients receive time sensitive evidence-based care so that lethal arrythmias are not missed.

Additional interventions can be implemented to further decrease the number of clinical alarms and to make changes to the current alarm management policy for the organization.

Keywords

Alarm Fatigue, Nursing, ICU, ECG, Critical Care

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