On this fascinating episode of RNFM Radio, we’re joined by Jeanne Venella, DNP, the Chief Nursing Officer of Milford, CT-based Bernoulli, a leader in real-time connected healthcare. Jeanne has spent her career transforming nursing care and improving processes. In combination with her Doctor of Nursing Practice degree, Jeanne brings both day-to-day operational experience and classroom theory to Bernoulli clients.
Her career includes positions with the Hospital of the University of Pennsylvania, Children’s Hospital of Philadelphia and Blue Jay Consulting. Her areas of expertise include adult and pediatric emergency nursing, organizational throughput, patient flow and efficiency, process improvement, change management, departmental designs, redesigns and physical plant layouts. Jeanne has been published in several nursing journals and is a frequent presenter on emergency care and nursing.
If you’d like to cajole your employer to look deeply at the issue of alarm fatigue, this episode will educate you on the salient issues, offering you tools and resources and knowledge for bringing this conversation to the table.
Here are some of the most salient points of interest to nurses and other hospital-based healthcare professionals:
1) The lack of hospital-wide clinical alarm management policies and procedures, and the inherent dangers associated with it, achieved prominence in 2013, with the release of the Joint Commission’s National Patient Safety Goal (NPSG) on clinical alarm safety.
2) The NPSG mandates that hospitals must identify and prioritize alarms based on internal considerations by Jan. 1, 2016. In Phase II, which also began in January, “hospitals will be expected to develop and implement specific components of policies and procedures. Education of those in the organization about alarm system management will also be required.”
3) While hospitals and health systems have made progress in solutions development, missed alarms due to poor communication or alarm fatigue continue to be a clear and present threat to patient safety. The increase in the number of medical devices with alarming capabilities has only exacerbated the problem, as has the lack of standards on the proper configuration of alarm parameters.
4) Up to 90 percent of all clinical alarms are non-actionable—meaning, they do not require intervention with a patient.
5) When alarms are more often false than true, the nursing staff’s sense of urgency in responding to alarms is diminished. In this syndrome of “clinical alarm fatigue,” the simple burden of alarms desensitizes caregivers to alarms. Noise levels associated with frequent alarms may also heighten patient anxiety and disrupt their perception of a healing environment. Alarm fatigue experienced by nurses and patients is a significant problem and innovative solutions are needed
6) Technology alone without input from the workforce can actually lead to lack of adaptation. Nurses and nursing leaders must get out ahead of this issue or solutions will not have the correct stakeholders represented. Clinical and IT leadership, including nurses, respiratory therapists, biomedical engineers and information technology staff, must come together to develop the policies and standards necessary to prioritize and reduce the number of alarms and setting protocols for altering current or default alarm parameters.
7) A major part of clinical alarm management—which is frequently overlooked—are strategies related to alarm reduction.
8) A baseline evaluation enables clinical leadership to begin the process of mapping alarm trends, as well as classifying alarms by frequency, alarm type, and device, variations by time and day, and rooms and units, alarm parameters and thresholds, and physiological vs. technical alarms.
9) One of the major challenges in alarm management is sorting clinically relevant alarms from nuisance alarms (i.e., a sensor on a patient detached momentarily or Wi-Fi momentarily disconnected). Hospitals need to develop a standard approach to the numbers of alarms and have a strategy around alarm fatigue, alarm reduction, and alarm noise.
BernoulliOne™, the company’s flagship platform, is the market’s only real-time, end-to-end, connected healthcare platform that combines comprehensive and vendor-agnostic medical device integration with powerful middleware, clinical surveillance, telemedicine/virtual ICU, advanced alarm management, predictive analytics and robust distribution capabilities into ONE solution. BernoulliOne™ empowers clinicians with tools to drive better outcomes, improve the patient experience, and enhance provider workflow. In November 2015, Cardiopulmonary Corp. merged with Nuvon, a leader in medical device connectivity and integration, creating Bernoulli.
Links to published bylines and interviews:
- Case Study: Achieving Clinical Clarity from Ventilator Overload
- Case Study: Wesley Medical Center: Beyond Alarm Management
- Article: The Alarms that Cried Wolf
- Article: Why it is time for an immediate hospital alarm intervention
- Article: Smarter Alarm Management Fights Alarm Fatigue” by Bernoulli CNO Jeanne Venella published in Medscape
- Webinar: The Threat of Alarm Fatigue on Patient Safety
ECRI Institute Patient Safety Organization: https://www.ecri.org
Joint Commission 2016 National Patient Safety Goals
- WEBSITE: http://bernoullihealth.com/
- TWITTER: https://twitter.com/BernoulliHealth
- LINKED IN: https://www.linkedin.com/company/553268
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