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.

 

What healthcare agencies require hearing from their Chief Information Security Officers?

After almost 8 years as chief information security officer (CISO) at the institute of Temple Health University Health System, Mitch Parker last September joined Indiana University Health. There, he told executives what he had told his team at Temple—cyber threats aren’t an information technology department issue but a security issue. Chief Information Security Officers who are new to an agency need to stress the problems that cyber threats represent and the adequacy, or lack thereof, of current security procedures, Parker stated Sunday during a presentation at HIMSS17.

That initiates with educating other executives about breaches—why they occur in the first place, the significance of discussing the technology behind breaches, but most significantly, the procedures and failures that cause breaches.

Chief Information Security Officers (CISOs) should talk about the cyber atmosphere using non-biased sources from firms like Gartner, Ponemon and health insurers to report to coworkers on trends and emerging threats. And Chief Information Security Officers (CISOs) require insisting that the agency join cyber threat sharing initiatives across their region and the industry.

Information security must be tied to 2 enterprise levels—information systems and the organization strategy, Parker stressed. “Metrics need to concentrate on augmenting and supporting the overall strategy,” he adds.

Parker recommended adopting the Lean methodology for improving security performance, as the program is all about process improvements and asking why less than optimal processes continue to exist. And workers responsible for information security, regardless of where in the agency, should be told that they require understanding Lean.

Moreover, Lean should be utilized to design and maintain systems covering business customers, enterprise architecture, legal contracting, compliance, supply chain and enterprise risk scoring, making sure that several teams are on the same page with security.

This is grunt work, Parker cautioned: “You cannot buy your way into this.”

If an agency decides to purchase cyber insurance, it must understand the requirement to complete a comprehensive risk assessment that includes pointed queries to determine the strength of the security program. Not merely are insurers looking for that assessment, but so also is the HHS Office for Civil Rights, which enforces the HIPAA privacy, security and breach notification rules.

Good information security, Parker claimed, has its hooks in clinical risk management, insurance, emergency preparedness, privacy, corporate compliance, supply chain, revenue cycle, information management and Joint Commission requirements, among others.

To be victorious with this laundry list, an agency must embrace change management in an overall enterprise model, Parker advised. “If one player claims, ‘I do my own change management,’ it will not work. Either there is one change management program or there is none.”