How alarm management software empowers response time of nurse

The Hospital for Special Care in Connecticut, a long-term acute-care facility, had an issue with alarm fatigue, specifically ventilator alarms that were nearly constantly going off. So the hospital bought alarm management software to get the issue under control and make better the patient comfort and safety. The software, from Bernoulli Enterprise, filters alarms and assists providers determine which kinds of alarms are most significant.

There are several ways in which a sufferer on a ventilator and breathing through a trachea tube can set off an alarm. They may cough, reposition, talk, exhale as the ventilator is delivering a breath, or have secretions that can stop delivery of a breath.

Every time an alarm sounded, it would also set off an alarm in the hallway, claims Connie Dills, respirator practice manager at the Hospital for Special Care. Because there was no way to know if an alarm was demonstrating a truly a crucial situation, nurses spent the day running around checking the sufferers; most alarms turned out to be non-actionable.

With the new alarm management software system, the hospital chose several core alarm metrics as the most significant to monitor—low exhale volume, low inspiratory pressure, patient disconnect, no information flowing and loss of connectivity between the ventilator and Bernoulli.

Alerts are reflected at workstations, on laptops and pagers, on an LED board and through an audible overhead speaker. With the new alarm management software, the hospital has observed an 80% reduction in the number of alarms for which an instant response is required, Dills claims.

Utilization of the Bernoulli software also supports new Joint Commission patient safety aims, which need nurses to conduct ventilator checks on each shift. The software generates reports that can show trends of alarms, a log of events and parameters on each ventilator.

Removing false alarms has enabled staff to respond quicker to what are perceived to be real emergencies. “Our response time is outstanding,” Dills claims. When an actionable alarm goes off, the response time is within 10 to 20 seconds.

Dills understand the reluctance of hospitals to pull out few particular alarms and concentrate on a core set because personnel in her hospital had their own qualms about that. “But if you do not filter some alarms out, you will not be better than before,” she suggests. And nurses will keep running around checking alarms instead of checking patients. “So, concentrate on the critical alarms for which you need immediate alerts,” she adds.

As with the introduction of most new information technologies into a hospital atmosphere, the Hospital for Special Care found some resistance to change when the new software went in, Dills states. But respiratory therapists—a very equipment- and tech-oriented bunch—became the clinician champions of the project and camped out in units to talk up the benefits and assist connect devices. Hospital departments that should be brought in to this kind of program involve IT, clinical engineering, and the safety and risk departments.