Nurses and clinicians are waging a losing war, not against sickness or budget shortfalls, but against the thousands of constantly-ringing alarms that flood every moment with screeches and beeps. 

An IV fell out (it didn’t). A patient’s heart stopped (it didn’t). A patient on bedrest stood up (they didn’t). These alarms are piercing, ever-present, and wrong most of the time, so it’s no wonder that nurses and doctors have lost their sense of urgency when another beep-boop goes beep-boop. 

But how can we still protect patients without alarms? How can nurses and doctors better separate the real alarms from the false positives? 

Paradoxically, can we use technology like medical computers and machine learning to fight the creeping problem of “too much technology” that is driving nurses and patients crazy in the first place?

What is Alarm Fatigue?

Alarm fatigue is the term for what happens to the mind, patience, and focus of a nurse or other clinician whose constant-vigilance is tested to the breaking point. 

The idea is that nurses are required to be on guard at all times, ready to spring into action at the slightest alarm. However, most of the alarms that go off in a patient’s room are errors or false-positives — often up to 90%, according to various studies. But, even with that knowledge, no alarm can be ignored — any one of them could be the alarm that helps save a patient’s life. So they must respond to every single alarm like it could be life-threatening, which is a terrible strain on anyone’s patience. 

This sensory fatigue ultimately leads to more than just stress — it actually leads to more frequently missed alarms. The human mind begins to drown out any constant noise — ask any parent with a toddler. 

Obviously, the increased stress and missed alarms are simply untenable. Sadly, the condition of alarm fatigue is also ever-present in today’s healthcare facilities. 

The Cause of Alarm Fatigue

The Joint Commission is a non-profit organization that evaluates and certifies healthcare institutions. According to the Joint Commission, alarm fatigue is caused by a few factors. 

The most obvious factor is alarm malfunction — a technical issue has simply caused the alarm to fail. Next comes poor or incomplete training by staff — they may have put the electrodes or sensors on incorrectly, or in a manner as to easily fall off during normal circumstances. 

Poor training can also lead to alarms being set too sensitively, or not being customized for the exact needs of the patient and their diagnosis.

Gathering Sensor Data

The first step toward tackling alarm fatigue is to record all instances of alarms going off and to include information like when the alarm went off, for how long, and for what reason. Whether or not the alarm was justified can also be recorded, alongside those nurses or clinicians that reported more frequent alarms than others.

Don’t worry about increasing paperwork, either — this data can be gathered without clinician input. For instance, when a patient lays on their IV line 17 times, it becomes clear to a sufficiently advanced computer that the alarm is most likely a reoccurring error. 

Machine Learning Reducing Alarm Fatigue

After data has been gathered and sufficiently analyzed, machine learning and algorithms can be used to make better decisions on when alarms go off. 

Called “alarm suppression algorithms,” these machine-learning solutions have already been tested successfully and proven to greatly reduce false alarms. These algorithms come in different shapes and functions, but the simple idea is that advanced machine learning can gather and synthesize years of already available data to determine normal working parameters for a sensor. It can then take incidents of false positives and compare them to false positives all around the world. It would take a team of people working around the clock forever to sort through that much data, but a computer can do it in literal seconds. 

Then, when a heart monitor or other sensor detects activity in the patient outside of its safe operating parameters, it can then be run past the computer, which can decide if an alarm event matches all of the symptoms of a false positive based on typical behavior.

The algorithm can then shut the alarm down and list it as an error. Now consider this happening every few seconds across the entire hospital, then multiply this by a whole county, state, or country, and you can imagine the positive changes in clinician fatigue levels across the board. 

What Can Staff Do?

Obviously, these algorithms (combined with interconnected sensors and medical PCs) are the biggest and most important weapon in the fight against alarm fatigue.

However, that doesn’t mean that healthcare providers, nurses, and doctors can’t take steps to improve the situation. First and most obvious is to get administrators and other people in power to recognize how devastating alarm fatigue can be. Show them reputable stats and studies that showcase how dangerous the situation can get when doctors and nurses start missing alarms. Form a committee or task force with members from every echelon of healthcare, from C-suite to in-the-field clinician. 

The second step is to provide in-house training and training follow-ups, not only on how to place and properly use all sensors and ECGs, but also on how to change the parameters of sensors manually depending on the patient. 

The method of alarm can also be customized for the most efficient use. Does every alarm need to be audio? Can it be changed to a notification sent to a central nursing computer, cell phone, or computer-on-wheels? Less dire alarms are perfect candidates for these changeovers — if the alarms signify changes that aren’t life-threatening, they probably don’t need to blare out loud at all hours of the night. 

The Infrastructure Needed to Relieve Alarm Fatigue

Of course, implementing machine learning algorithms and better sensor placement and programming training doesn’t happen overnight. A strong baseline of secure medical computers, improved network connectivity, and medical “Internet of Things” sensors are all required to solve this pervasive and insidious form of work stress.

The better alarms are, the fresher doctors are, the better health outcomes for patients everywhere. To learn more about the equipment you need to tackle alarm fatigue, contact Cybernet today.