Clinical Alarms Management in the Intermediate Cardiology and Cardiovascular Intensive Care Units at the University of Iowa Hospital and Clinics

The Intermediate Cardiology Unit (4RC) and the Cardiovascular Intensive Care Unit (CVICU) at the University of Iowa Hospital (UIHC) experience a significant amount of clinical alarms that they have to manage. The clinical alarms monitors have thirty-four different vital signs for patients in the two units, and an alarm will sound when a vital sign or rhythm starts to signal abnormalities. Some of the abnormalities are triggered by a valid clinical condition of the patient, also called an actionable alarm. Alarms that do not fall into the actionable alarm category, called non-actionable and false alarms, have led to alarm fatigue among registered nurses (RNs) and respiratory therapists (RTs) in both units. Alarm fatigue prevents staff from responding appropriately to clinical alarms, resulting in major patient safety issues. The goal of the study is to reduce the number of non-actionable and false alarms by improving alarm management. After alarms per hour per bed were collected for each unit at their current state, an educational program was developed and introduced to the staff in 4RC in an attempt to reduce the alarms per hour per bed. CVICU was treated as a control group with no intervention provided while the educational program was introduced to 4RC RNs. CVICU was held as a control group to determine if mean alarms per hour per bed went down independently with time. Results from both units after the educational program intervention show that the educational program was not effective in decreasing alarms per hour per bed. RNs and RTs still face significant barriers in managing their alarms properly in 4RC and CVICU, and further research needs to be conducted to impact the clinical alarm management problem.