NR 439 Week 2 Discussion

NR 439 Week 2 Discussion

Student Name

Chamberlain University

NR-439: RN Evidence-Based Practice

Prof. Name:

Date

Reflecting on a Nursing Clinical Issue: Alarm Fatigue in a Telemetry Unit

Introduction to the Clinical Issue

In my practice on a telemetry step-down unit, I have observed that multiple alarms frequently go off throughout the workday, including sounds from ventilators, call lights, bed alarms, video monitors for high-risk patients, IV pumps, and cardiac monitoring systems. The constant barrage of alarms leads to alarm fatigue, a phenomenon where the frequent occurrence of alarms results in delayed or non-response from nurses. This situation poses a potential threat to patient safety and care quality. To address this issue, my facility has assigned dedicated monitor technicians to continuously observe cardiac rhythms. However, this solution alone has not been sufficient to reduce the risk of alarm fatigue.

Formulating the PICO(T) Question

To explore evidence-based solutions, I developed a PICO(T) question:

• P (Population): Nurses working on telemetry units with continuous telemonitoring.
• I (Intervention): Strategies to reduce nonaction-required alarms and prevent unnecessary responses.
• C (Comparison): Current practices without alarm-setting adjustments or customized monitoring.
• O (Outcome): Reduction in alarm fatigue and improved response to critical alarms.
• T (Time): Over a defined observational period.

The question is as follows:
By working on a telemetry unit with continuous telemonitoring, how can we reduce nonaction-required alarms from sounding and prevent inessential actions for cardiac monitoring?

Relevance of the Study to the Clinical Issue

The study by Jahrsdoerfer (2016), titled Reducing Interruption Fatigue through Improved Alarm Support, offers insights into addressing alarm fatigue. The study highlights how modifying telemonitoring systems based on individual patient needs and implementing daily cardiac lead changes with proper skin preparation can significantly reduce unnecessary alarms. For life-threatening conditions, alarms were retained for rhythms such as asystole, ventricular tachycardia, and apnea, ensuring critical events were prioritized. This quasi-experimental study was conducted in various hospital units, including ICUs and telemetry units, covering 52 beds. The results demonstrated a 25% reduction in alarms, showcasing the effectiveness of customized settings and targeted interventions.

Tabular Summary of Key Elements

References

Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Sudbury, MA: Jones and Bartlett.

NR 439 Week 2 Discussion

Jahrsdoerfer, M. (2016). Reducing interruption fatigue through improved alarm support. Biomedical Instrumentation & Technology, 50(2), 109–113.