AAMI News May 2017

Coalition Looks to Build Database to Help Reduce Clinical Alarms

Alarm FatigueThe AAMI Foundation’s National Coalition for Alarm Management Safety plans to create a free online database that will allow hospitals to upload and compare common monitor default limits or “cut points.” Creating this database is part of a broader initiative aimed at helping hospitals slash the number of nonactionable alarms and alerts issued by physiologic monitors.

“Data identifies opportunities for improvement, and when properly organized, provides useful information that can serve as the basis for decision making,” said Audre Pocius, a registered nurse in Rush University Medical Center’s Neonatal Intensive Care Unit. “You cannot improve what you don’t know.”

Many hospitals are able to capture the total number of physiologic monitor alarms, which includes critical, noncritical, and advisory alarms, but do not have a way to benchmark the default limits programmed into the devices that trigger these alerts, according to Pocius. Additionally, some hospitals continue to struggle to obtain the number of alarms issued by monitors.

Initial alarm settings for parameters such as heart rate, blood oxygen levels (SpO2), and respiratory rate can be personalized based on where in the hospital the monitor is being used (e.g., neonatal intensive care unit, adult intensive care unit, or medical-surgical unit) and other characteristics of the patient. These settings also can vary across hospitals.

“This database can fill the gap where there is a lack of published best practices and guidelines of monitor default limits,” Pocius, who is a member of the coalition, added. “We are hopeful this application will provide useful and meaningful data to institutions and clinicians specifically related to setting appropriate monitor default limits that can help reduce nonactionable alarms and improve patient outcomes.”

The architecture of the alarm database will be based on a similar online resource developed for infusion pumps by the Regenstrief National Center for Medical Device Informatics (REMEDI)—a project that garnered the AAMI Foundation and Institute for Technology in Health Care 2017 Clinical Solutions Award.

“We all want information—the more the better—to be able to benchmark it,” said Richard Zink, managing director of operations for Regenstrief Center for Healthcare Engineering based at Purdue University in West Lafayette, IN, and the leader of the REMEDI project. “But in order to use the data in the new system, you will have to provide data.”

The working group hopes to launch the online data collection phase of the project by the end of the summer. REMEDI is also collaborating with the AAMI Foundation on a related initiative to reduce ventilator alarms through the benchmarking of default parameters. More information about uploading data for both initiatives will be available through catalyzecare.org/remedi.