Clinical Alarms in a Gynaecological Surgical Unit: A Retrospective Data Analysis

Abstract

Alarm fatigue refers to the desensitisation of medical staff to patient monitor clinical alarms, which may lead to slower response time or total ignorance of alarms and thereby affects patient safety. The reasons behind alarm fatigue are complex; the main contributing factors include the high number of alarms and the poor positive predictive value of alarms. The study was performed in the Surgery and Anaesthesia Unit of the Women's Hospital, Helsinki, by collecting data from patient monitoring device clinical alarms and patient characteristics from surgical operations. We descriptively analysed the data and statistically analysed the differences in alarm types between weekdays and weekends, using chi-squared, for a total of eight monitors with 562 patients. The most common operational procedure was caesarean section, of which 149 were performed (15.7%). Statistically significant differences existed in alarm types and procedures between weekdays and weekends. The number of alarms produced was 11.7 per patient. In total, 4698 (71.5%) alarms were technical and 1873 (28.5%) were physiological. The most common physiological alarm type was low pulse oximetry, with a total of 437 (23.3%). Of all the alarms, the number of alarms either acknowledged or silenced was 1234 (18.8%). A notable phenomenon in the study unit was alarm fatigue. Greater customisation of patient monitors for different settings is needed to reduce the number of alarms that do not have clinical significance.

Keywords: alarm fatigue; anaesthesiology; clinical alarms; gynaecological surgery; monitor customisation; patient safety.