Implementing a Unit-Based Alarm Management Bundle for Critical Care Nurses

Abstract

Background: Clinical alarms are designed to signal an unsatisfactory patient physiological state and alert staff members to malfunctioning medical equipment. Alarm desensitization and fatigue can occur when clinicians are exposed to an overwhelming number of clinical alarms, particularly nonactionable alarms.

Local problem: Alarm fatigue and alarm management competency related to use of Philips monitoring systems were noted to be problematic among nurses working in the 27-bed surgical intensive care unit of a teaching hospital in northeastern Florida.

Methods: A quality improvement project was conducted to reduce alarm fatigue and improve nursing competency in managing alarms. The CEASE (Communication, Electrodes, Appropriateness, Setup, and Education) evidence-based alarm management bundle was implemented on the unit, and a representative from the alarm manufacturer conducted in-service training sessions. A clinical alarms survey developed by the Healthcare Technology Foundation was distributed both before and after the intervention to 115 nurses working in the unit. Descriptive and inferential statistics were used to assess for differences between the preintervention and postintervention periods.

Results: Nurse participants demonstrated improved alarm management competency, resulting in significant improvements in their perceptions of alarm functionality, settings, response time, and policy adherence. There was a statistically significant decrease in self-reported alarm fatigue, and the CEASE bundle was found to influence nursing practice.

Conclusions: The Joint Commission's 2022 goal of improving clinical alarm safety remains a top priority nationwide. Implementation of the CEASE alarm management bundle was effective in reducing surgical intensive care unit nurses' alarm fatigue and improving their alarm management practices.