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Alarm hazards as patient safety concern

· Kim Tucker,

Year after year, we’ve seen “alarm fatigue” ranked high on the ECRI Institute annual list of Top Ten Health Technology Hazards. Seemingly a fact of life in modern care, alarm fatigue as a source of potential trouble and its magnitude in patient care delivery stems from three facts:

  1. Nurses typically engage in more than 100 patient care and related activities per eight-hour shift. [1]
  2. These same nurses incur an average of 6.7 interruptions per hour,2 and as many as 14 interruptions per hour – 21 percent of them during tasks such as medication delivery and verification that pose a high risk to patient safety.3
  3. Each interruption when a nurse is preparing and administering medications is associated with a 12.1 percent increase in procedural failures and a 12.7 percent increase in clinical errors. At four interruptions, the risk of a major error doubles.4

Why so many interruptions that pose so much risk? As we introduced more technology into the care environment, alarms became essential to the care process. Because of this, any attempt to reduce the quantity of alarms must also avoid introducing a potentially more severe hazard. The real starting question then becomes: How can we increase the quality of alarms? 

To assess the quality of alarms, we should break them down into type and assignment, priority, and context and action.

Type and assignment

While technology systems have become very reliable at delivering meaningful alarms based on source conditions, the assignment of each alarm to the right clinician continues to be a manual process for most hospitals. When reliable delivery is combined with optimal assignment and escalation, we can eliminate unnecessary alarms to clinicians and improve time-to-response rate.


As healthcare enterprises adopt mobile technologies, the most effective notification systems send alarms to nurses and other clinicians at the point of care. By localizing alarm delivery to a mobile form factor, clinicians should be able to easily differentiate alarm priority via visual, auditory, and sensory cues—critical to minimizing untimely interruptions to patient care.

Distinction from Alerts

A final consideration in avoiding alarm hazards is making it easy for the recipient to distinguish between alarms and alerts. It also helps if alerts are delivered with patient context, especially when it will minimize the time it takes to decide whether an alert requires immediate attention.

This is the second of the 4 Ways Clinical Mobility Protects Patients at your Hospital. See the Data Integrity as a Patient Safety Concern, and stay tuned for more on Medication Reconciliation and Patient Handoffs and Transport in the coming weeks!

Learn more on the importance of adopting contextual communications, and how a secure, enterprise-wide solution can leverage the synergy of a wide network of users to add value in patient care. Download “The Need for Context-Aware Clinical Communication.” Download White Paper

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