Alarm Fatigue
Theories in nursing generally center on the relationship of four concepts -- nursing, environment, person and health. These concepts are interrelated and impact one another in diverse ways, often seen in issues of nursing when problems arise that require analysis. The issue of alarm fatigue is one problem in nursing that touches on each of these four concepts. Alarm fatigue can be defined as exhaustion that occurs for nurses when they are exposed to many alarms throughout their shift, which causes "sensory overload" and the nurses to develop a "non-existent response to alarms" (Horkan, 2014, p. 83). Complacency and dissension can follow in the nursing workplace as too many alarms for nurses can render them unresponsive.

Alarms are needed in nursing because they alert nurses and care providers to emergency situations that require immediate action and intervention, especially in the intensive care unit. However, nurses and staff work in an…...

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References

Despins, L., Scott-Cawiezell, J., Rouder, J. (2010). Detection of patient risk by nurses:

a theoretical framework. Journal of Advanced Nursing, 66(2): 465-474.

Horkan, A. M. (2014). Alarm fatigue and patient safety. Nephrology Nursing Journal,

47(1): 83-85.

Alarm Fatigue
Ethics Committee Proposal: Alarm Fatigue

Alarm fatigue is a serious issue that is faced by nurses and other medical staff on a daily basis. It is not just a concern for the staff, but also for the patients. There is a possibility that they will not get the proper care in a timely manner if the medical personnel are not responding quickly and accurately to the alarms that go off in patient rooms (Blum & Tremper, 2010). If that is the case, then the issue also becomes one of ethics, as it impacts whether patients are being mistreated or whether their outcomes may be different (McNeer, et al., 2007). That has to be carefully addressed, and solutions need to be found, in order to make sure alarm fatigue does not result in patient injury or death due to missed cues by medical personnel.

Objectives

There are two proposal objectives discussed here. Both…...

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References

Blum, J.M., & Tremper, K.K. (2010). Alarms in the intensive care unit: Too much of a good thing is dangerous: Is it time to add some intelligence to alarms? Critical Care Medicine, 38(2): 702 -- 703.

Bustamante, E.A., Bliss, J.P., & Anderson, B.L. (2007). Effects of varying the threshold of alarm systems and workload on human performance. Ergonomics, 50(7):1127-1147.

McNeer, R.R., Bohorquez, J., Ozdamar, O., Varon, A.J., & Barach, P. (2007). A new paradigm for the design of audible alarms that convey urgency information. Journal of Clinical Monitoring and Computing, 21(6):353-363.

Alarm Fatigue
When someone is exposed to a frequent number of alarms, no matter what type or in what context, that person can easily become fatigued from the sound of them going off all the time. When that happens, the person becomes completely desensitized to the alarms, and that can lead to not answering the alarms in a timely manner, or even missing some of them completely (Aztema & Schull, 2006). At some point, the person starts to "tune out" the alarms, because he or she hears them so frequently that they cease to have the meaning they should. They become background noise, and that slows reaction time (Mondor & Finley, 2003). There are a number of situations in which this can occur, and there are various industries that see the problem of alarm fatigue occurring among workers. One of these industries is healthcare, where nurses and other healthcare workers can…...

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References

Atzema, C., & Schull, M.J. (2006). Alarmed: Adverse events in low-risk patients with chest pain receiving electrocardiographic monitoring in the emergency department: A pilot study. American Journal of Emergency Medicine, 24(1):62-67.

Bliss, J., Fallon, C.K., & Nica, N. (2007). The role of alarm signal duration as a cure for alarm validity. Applied Ergonomics, 38(2):191-199.

Blum, J.M., & Tremper, K.K. (2010). Alarms in the intensive care unit: Too much of a good thing is dangerous: Is it time to add some intelligence to alarms? Critical Care Medicine, 38(2): 702 -- 703.

Borowski, M., Gorges, M., Fried, R., Such, O., Wrede, C., & Imhoff, M. (2011). Medical device alarms. Biomedizinische Technik. Biomedical engineering, 56(2): 73 -- 83.

Interdisciplinary Consideration -- Alarm Fatigue
Interdisciplinary Consideration: Alarm Fatigue

Alarm fatigue is a very real problem for a number of people in various disciplines. It occurs when alarms go off so much that people begin to tune them out. That could mean ignoring something that would be very important to note, and could end up putting patients at risk of serious injury and even death. Two of the disciplines where alarm fatigue is a serious problem include nursing and surgery. In both areas there are many alarms going off, alerting medical personnel of various conditions. However, "alarms" may not really be the right word for these sounds. A number of the noises that occur are more closely based on notifying people of something, as opposed to an actual alarm that is set to indicate a true emergency. Clearly, changes need to be made that can help both nurses and surgeons know when…...

PROFESSIONAL CAPSTONE 9Alarm Fatigue and How to Reduce ItAbstractAlarm fatigue is a fundamental problem facing healthcare professionals today. It is defined as sensory overload that occurs when healthcare professionals are exposed to the constant noise of medical device alarms, leading to desensitization that results in delayed response or missed alarms altogether (Chromik et al., 2022). The hypothesis statement for the proposed research project is that alarm management training would be beneficial in reducing alarm fatigue as well as the number of false and nuisance alarms at the selected project site. This text presents information to support the above hypothesis statement and outlines the benefits of the proposed project on patients, the facility, business operations, medical professionals, and the society. Evidence from randomized clinical trials, quasi-experimental studies, and integrated reviews shows that staff education would effectively reduce alarm fatigue among nurses, although the greatest effect would be felt when the education…...

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References

Bai, G., & Zare, H. (2020). Hospital cost structure and the implications on cost management during Covid19. Journal of General Internal Medicine, 35(9), 2807-2809.

Baker, J. L. (2000). Evaluating the impact of developing projects on poverty: a handbook for practitioners. World Bank Publications.

Chromik, J., Klopfenstein, S., Pfitzner, B., Sinno, Z., Arnrich, B., Balzer, F., & Poncette, A. (2022). Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review. Frontiers in Digital Health, 4(1), 843747. Doi:10.3389/fdgth.2022.843747

Alarm Fatigue and How to Reduce ItThe selected research topic is alarm fatigue and how to reduce it. Alarm fatigue can be defined as sensory overload that occurs when healthcare professionals are exposed to the constant noise of medical device alarms, leading to desensitization that results in delayed response or missed alarms altogether (Chromik et al., 2022). This assignment details why this topic was selected. It begins with a discussion of the difference between primary and secondary research to lay the foundation for the research procedures that will be carried out.Difference between Primary and Secondary ResearchAccording to Jugenheimer et al. (2014), primary research could be conceptualized as research that involves collecting original data first hand from participants to address a specific research problem. It is important to note that in primary research, the researcher gathers the information themselves rather than relying on information available in existing publications and databases. The…...

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References

Agency for Healthcare Research and Quality (AHRQ) (2019). Alert fatigue. AHRQ.  https://psnet.ahrq.gov/primer/alert-fatigue 

Chromik, J., Klopfenstein, S., Pfitzner, B., Sinno, Z., Arnrich, B., Balzer, F. & Poncette, A. (2022). Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review. Frontiers in Digital Health, 4(1), 843-847. Doi: 10.3389/fdgth.2022.843747

Gaines, K. (2022). Alarm fatigue is way too real (and scary) for nurses. Nurse.org.  https://nurse.org/articles/alarm-fatigue-statistics-patient-safety/

PROFESSIONAL CAPSTONE 6Alarm Fatigue and How to Reduce It: Key StakeholdersThe selected research topic is Alarm Fatigue and How to Reduce It. As Chromik et al. (2022) indicate, alarm fatigue is sensory overload that occurs when healthcare professionals are exposed to the constant noise of medical device alarms, leading to desensitization that results in delayed response or missed alarms altogether. Based on the available literature, the research hypothesizes that alarm management training would be beneficial in reducing alarm fatigue and non-actionable alarms among nurses. This assignment identifies the key stakeholders in the research and their roles and also explores potential barriers that could affect the incorporation of the project findings at the selected clinical site.Key Stakeholders and their Relationship to the ProjectStakeholders in the project could be divided into two: internal and external stakeholders. Internal stakeholders enjoy a direct relationship with the healthcare organization through investment, ownership, or employment. External…...

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References

Chromik, J., Klopfenstein, S., Pfitzner, B., Sinno, Z., Arnrich, B., Balzer, F., & Poncette, A.

(2022). Computational approaches to alleviate alarm fatigue in intensive care medicine:

A systematic literature review. Frontiers in Digital Health, 4(1), 843747. Doi:

Alarm Fatigue
Evaluation Plan: Alarm Fatigue

In order to determine the effectiveness of the plan to combat alarm fatigue, which involves changing the sounds that the alarms use in order to make them more audible and less likely to be "tuned out" by medical personnel, specific criteria are needed. These criteria will be used in order to decide whether the plan is effective, or whether it is necessary to consider and address other changes that will be used in place of the new plan or in addition to it. As nurses and other medical personnel work through the new plan and get used to the new alarms, there may be changes that have to be made. The goal of the objective criteria and examination of them is to determine whether these changes are needed and if they are changes that can be implemented. These objective criteria are:

Nurses and other medical personnel…...

CAPSTONE POJECT SOUCES 2Alarm Fatigue and How to educe ItNameUniversityCourseInstructorDateCapstone Project Sources1. Impact of alarm fatigue on the work of nursesa. eference: Lewandowska, K., Weisbrot, M., Cieloszyk, A., Medrzycka-Dabrowska, W., Krupa, S., & Ozga, D. (2020). Impact of alarm fatigue on the work of nurses in an intensive care environment: A systematic review. International Journal of Environmental esearch and Public Health, 17(22), 8409. Doi: 10.3390/ijerph17228409b. Date of Publication: 2020c. Authors: Katarzyna Lewandowska, Magdalena Weisbrot, Aleksandra Cieloczyk, Wioletta Medrzycka, Sabina Krupa and Dorota Ozgad. Bias: There was no apparent bias in the studye. Precisely Completed: The study appears to have been precisely completed, although precision could be enhanced by increasing the number of reviewed studies. elevant studies were sourced from recognized databases such as Cochrane Library, ProQuest Nursery, EBSCO, OVID, and PubMed. 7 studies were included in the final review and data analyzed both quantitatively and descriptively, with a total of…...

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References Bi, J., Yin, X., Li, H., Gao, R., Zhang, Q., Zhong, T., Zan, T., Guan, B., & Li, Z. (2020). Effects of monitor alarm management training on nurses’ alarm fatigue: A randomized controlled trial. Journal of Clinical Nursing, 29(21), 4203-4216. Dee, S. A., Tucciarone, J., Plotkin, G., & Mallilo, C. (2022). Determining the impact of an alarm management program on alarm fatigue among ICU and telemetry RNs: An evidence-based research project. The Journal of School Nursing, 8(1), Doi: 10.1177/23779608221098713Lewandowska, K., Weisbrot, M., Cieloszyk, A., Medrzycka-Dabrowska, W., Krupa, S., & Ozga, D. (2020). Impact of alarm fatigue on the work of nurses in an intensive care environment: A systematic review. International Journal of Environmental Research and Public Health, 17(22), 8409. Doi: 10.3390/ijerph17228409Lewis, C.L., & Oster, C. A. (2019). Research outcomes of implementing CEASE: An innovative, nurse-driven, evidence-based, patient-customized monitoring bundle to decrease alarm fatigue in the intensive care unit/step-down unit. Dimensions of Critical Care Nursing, 38(3), 160-173. Nyarko, B.A., Nie, H., Yin, Z., Chai, X., & Yue, L. (2022). The effect of educational interventions in managing nurses’ alarm fatigue: An integrative review. Journal of Clinical Nursing, 32(13), 2985-2997.

.....clinician responses to alarms? For example: Physical barriers, physical layout of the unit, RN-pt ratio.
The observed influences include the type of alarm, such as whether it was a bed or bathroom alarm versus a technology alarm coming from something like the IV pump.

2. How, as a student, are you educated about alarms and your response to them? How might education regarding the various patient alarms be an issue associated with alarm response?

I have done some research on the clinical implications of alarms and alarm fatigue. For example, Cyach, et al. (n.d.) found that too many alarms causes alarm fatigue, and also creates a "false sense of security," (p. 5). The researchers also found that staff is sometimes not educated about the different types of alarms and what they mean.

3. Who is responsible for alarm response?

The delegation of authority for responses will vary from case to case. In the clinical setting…...

Comair Flight 5191: Case Study in Fatigue
Aviation Safety: Fatigue

Comair Flight 5191: A Case Study in Fatigue

Comair Flight 5191: A Case Study in Fatigue

Comair Flight 5191 came to a disastrous end in 2006 when the flight crew attempted to take off from a runway much shorter than required for the aircraft they were piloting, resulting in the deaths of 49 of the 50 people on board (Pruchnicki, Wu, and Belenky, 2011). The Comair Captain, First Officer, and air traffic controller failed to perform the necessary checks to ensure the plane was lined up on the proper runway before takeoff. The National Transportation Safety Board (NTSB) investigated the accident and could not definitively determine the cause. Years later at a sleep conference, the NTSB chairman Deborah Hersman mentioned the Comair Flight 5191 tragedy and noted that establishing fatigue as a significant contributing factor is often so difficult that it is only offered…...

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References

Caldwell, John A. (2012). Crew schedules, sleep deprivation, and aviation performance. Current Directions in Psychological Science, 21(2), 85-89.

Hersman, Deborah A.P. (2010). Remarks of the Honorable Deborah A.P. Hersman, Chairman National Transportation Safety Board before the National Sleep Foundation in Washington, D.C. NTSB.gov. Retrieved 14 Feb. 2013 from   / speeches/hersman/daph100305.html.http://www.ntsb.gov/news 

Jackson, Craig A. And Earl, Laurie. (2006). Prevalence of fatigue among commercial pilots. Occupational Medicine, 56, 263-268.

Pruchnicki, Shawn A., Wu, Lora J., and Belenky, Gregory. (2011). An exploration of the utility of mathematical modeling predicting fatigue from sleep/wake history and circadian phase applied in accident analysis and prevention: The crash of Comair Flight 5191. Accident Analysis and Prevention, 43, 1056-1061.

Alarm fatigue reduces quality of care and adversely affects the quality of the workplace environment for healthcare staff. Therefore, comprehensive alarm management strategies should become a cornerstone of healthcare administration. Using diffusion of innovation theory, this paper has shown how administrators can develop effective alarm management strategies.
Alarm management strategies may vary depending on the nursing context, but generally there are several components to alarm management including helping nurses recognize patient risk signals, psychological sifting, reducing unnecessary alarms, and improving the audible quality of alarms by working with technology manufacturers. Different types of alarms can and should be handled by dedicated staff. For example, technical alarms that indicate equipment malfunctions could be directly channeled into equipment technician receivers rather than being broadcast throughout the nursing department. Nursing staff also needs to be trained regularly when new equipment is installed, so that the different sounds of alarms can be distinguished from one…...

Alarm Fatigue esolution
Project Timeline from Implementation to Evaluation

Alarm fatigue resolution project is a critical project in the health care department and needs cautious implementation with minimal or no disruption of the daily activities in the care of patients. The approximate period for the implementation of this project and an evaluation thereafter will be three months. Four sequential processes will characterize project within the three months as follows:

Stage 1: Planning, ordering and putting up the implementation material and gathering the project implementation team (both technical and supportive) -- This will be done in the first three weeks. It is the first phase of this project and is vital for the realization of the entire implementation. Planning and gathering the project team together will allow sufficient time for consultation and discussion for this project and the way the implementation will continue as planned (Huber, 2010).

Stage 2: Identification of all the alarm…...

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References

Cleland, D.I. (1999). Project management: strategic design and implementation (3rd ed.). New York: McGraw-Hill.

Huber, D. (2010). Leadership and nursing care management (4th ed.). Maryland Heights, Mo.: Saunders.

Kerzner, H. (2004). Advanced project management: best practices on implementation (2nd ed.). Hoboken, N.J.: Wiley.

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Circadian Rhythm Test responses (cont'd)

Responses to Question, "What time do you need to get up each morning?"

Circadian Rhythm Test responses (cont'd)

Responses to Statement, "Describe how you sleep. (Assume you need to wake up at a certain time each morning.): How I fall asleep"

Circadian Rhythm Test responses (cont'd)

Responses to Statement, "Describe how you sleep. (Assume you need to wake up at a certain time each morning.): My ability to stay asleep at night."

Circadian Rhythm Test responses (cont'd)

Responses to Statement, "How my body naturally wakes up."

Circadian Rhythm Test responses (cont'd)

Responses to Question, "What time of year do you notice sleep, energy or mood problems?"

Circadian Rhythm Test responses (cont'd)

Responses to Question, "What time of year do you notice sleep, energy or mood problems? Ends"

Recommendations

Educate pilots concerning the need for regular healthy meals when operating conditions allow; carriers can help in this area by providing catered in-flight meal service, healthy choices at airport diners,…...

The assumption here is that ounselor burnout may be heightened as a result of the diversity of students who attend post seondary eduational institutions, and the variety of servies the 2-year postseondary ounselors must provide to these students. This assumption is ongruent with the findings of a study by Wilkerson and Bellini (2006) who advise, "Professional shool ounselors are asked to perform multiple duties as part of their daily work. Some of these duties math the desriptions set forth by national standards for shool ounseling programs, whereas others do not" (p. 440).
Consequently, shool ounselors are required to formulate deisions on a daily basis onerning the best way to perform their jobs (Wilkerson & Bellini). Not surprisingly, many shool ounselors are overwhelmed by these onstantly hanging working onditions and requirements, and a number of ounselors experiene high levels of stress as a result. Beause the onnetion between high levels of…...

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cited in Angerer, 2003). Unfortunately, it would seem that most helping professionals, including counselors, possess characteristics which predisposed them to this construct. For example, Lambie notes that, "Counselors may have increased susceptibility to burnout because of their training to be empathic which is essential to the formation of a therapeutic relationship. In fact, research has found counselor empathy to account for two thirds of the variance in supporting clients' positive behavioral change" (p. 32). The ability to remain empathic to the plights and challenges typically being experienced by students in community colleges is complicated by the enormous diversity that is increasingly characterizing these institutions, of course, but all helping professionals run the risk of becoming burned out while performing their responsibilities by virtue of their empathic sharing. In this regard, Lambie emphasizes that, "Empathy helps counselors understand the client's experience, but at the same time, a counselor may experience the emotional pain of multiple traumatized clients. Empathy is a double-edged sword; it is simultaneously your greatest asset and a point of real vulnerability; therefore, a fundamental skill of effective counselors, being empathic, may place counselors at high risk for burnout" (p. 33).

Citing the alarming results of a national survey of counselors that indicated that incidence may be almost 40%, Lambie also emphasizes that although all professions involve some degree of stress, counselors and other human service providers are at higher risk of burnout compared to other professionals. For example, this author notes that, "Counseling professionals are often in close contact with people who are in pain and distress. This continuous exposure to others' despair, combined with rare opportunities to share the benefits of clients' successes, heightens counselors' risk for burnout" (Lambie, p. 34). Other authorities confirm the incidence of burnout among educators, and cite even higher rates than the foregoing estimate. For instance, Cheek, Bradley and Lan (2003) report that, "Based on several international studies, approximately 60% to 70% of all teachers repeatedly show symptoms of stress, and a minimum of 30% of all educators show distinct symptoms of burnout" (p. 204). Indeed, a study by Lumsden (1998) determined that overall teacher morale was sufficiently severe that fully 40% of the educators who were surveyed indicated they would not choose teaching again as a career, and far more than half (57%) remained undecided at the time concerning ending their teaching career, were actively making plans to leave teaching, or would opt to leave the teaching field in the event a superior opportunity presented itself.

There are some other qualities that typify school counselors that may predispose them to becoming burned out over the course of time (some quicker than others, of course), but which may reasonably be expected to adversely effect the ability of school counselors to maintain their effectiveness in the workplace. For instance, Lambie concludes that, "Common counselor qualities of being selfless (i.e., putting others first), working long hours, and doing whatever it takes to help a client place them at higher susceptibility to burnout. As a result, counselors may themselves need assistance in dealing with the emotional pressures of their work" (p. 34).

Counselors and Characteristics of Burnout

Much