Managing Alarms in Acute Care Across the Life Span: Electrocardiography and Pulse Oximetry

Answers questions about ECG and pulse oximetry monitoring to decrease incidence of false alarms and alarm fatigue.

Scope and Impact of the Problem

Alarm fatigue is a patient safety risk, occurring when clinicians are exposed to excessive numbers of alarms, particularly false and clinically insignificant alarms. This overexposure results in sensory overload and desensitization to alarms. Consequently, response to alarms may be delayed or alarms may be missed altogether. Patients’ deaths have been attributed to alarm fatigue when a serious clinical event was missed because the alarm was not heard or was assumed to be false.¹ In recent studies,^2,3 from 89% to 99% of electrocardiographic (ECG) monitor alarms were found to be false or clinically insignificant. To date, clinical strategies to reduce alarms and alarm fatigue have been focused on ECG and oxygen saturation (Spo2) alarms. However, evidence for these strategies is limited. Interventions presented here are primarily sup- ported by expert opinion and/or have demonstrated success in quality improvement projects. To reduce false and clinically insignificant alarms and alarm fatigue, clinical units should assess their alarm burden and select interventions that address unit-specic needs.