The entire medical device community as well as middleware companies are focused on alarm management, namely the area of alarm reduction, as a means to mitigate alarm fatigue and in conjunction with the Joint Commission's National Patient Safety Goal.
As a veteran in the medical device space of three decades this is significant work in terms of bettering patient outcomes. I can recall all kinds of experiences within the clinical setting in which caregivers simply disregarded patient alarms or a time out and escalation of alarms occurs due to overload felt by the clinician.
The bottom line with all of the connectivity solutions now being promulgated with mobility solutions is that it is important to have the clinician be able to focus only on the relevant or actionable alarms. In effect, reducing the overall volume and number of nuisance alarms.
Incomplete, ineffective, or nonexistent alarm management protocols are more common place than not it appears. The solution is multi-faceted, but achievable. First it is necessary to tailor the patient alarm profile to the actual clinical condition. For example if the patient is in chronic A-Fib, maybe you need to turn off or lower threshold of the irregular heartrate alarm.
Next is to look at the application layer and its ability to tailor the suspension of alarms per a defined profile. As another example, if the patient SPO2 level drops below the threshold limit but self-corrects within three seconds, would this require an alarm dispatch to the mobile device? Is this stand-alone event clinically significant?
Clinical leadership must correlate data and patient conditions to determine what constitutes actionable versus nuisance alarms.
Cvach, et. al., writing in the Journal of Nursing Care Quality (http://journals.lww.com/jncqjournal/Fulltext/2014/01000/Use_of_Pagers_With_an_Alarm_Escalation_System_to.2.aspx) documents the substantial reduction in nuisance alarms that are possible by combining this two-pronged adjusting in both monitor thresholds as well as utilizing the suspension feature in their alarm management middleware.
This clinically driven alarm and event model is serving the purpose of drastically lowering false patient alarms, while engaging the critical expertise used in an efficient and financially driven model of care.
