Alarmed and potentially dangerous
Ever since she was a little girl, Jocelyn McKinley wanted to be a biomedical engineer. Her mother says she has kept a journal of ideas and inventions. Jocelyn’s seventh grade teachers confirmed that she excelled in math and science and they recommended her for an American Association of University Women sponsorship to attend Tech Trek held at UC Davis last summer.
Designed for girls entering 8th grade in the fall, Tech Trek allows them to explore science, technology, engineering and math (STEM) careers.
In preparation for Tech Trek, 11-year-old Jocelyn attended a Nevada County AAUW and Nevada Union High School event to hear from women in STEM careers.
One presentation that piqued Jocelyn’s interest was from a UCSF professor and research scientist, Barbara Drew. Drew’s research raised awareness of the problem of alarm fatigue experienced by doctors and nurses in hospital intensive care units. Patients in the ICU are connected to heart monitor devices that measure their electrocardiograms and vital signs and trigger audible alarms when the device senses an abnormality. Drew found that ICU patients at UCSF Medical Center had an average of 187 alarms per day and that 89% of them were false.
Other researchers have subsequently published that in hospital ICUs across the United States, alarms on patient-monitoring devices create a cacophony of noise day and night — beeping, pinging and ringing.
In response to the alarm fatigue problem, the Joint Commission that approves hospitals for accreditation has established alarm management as a national patient safety goal. So when the Joint Commission evaluates hospitals like our community hospital, they want to see policies and procedures related to alarm management.
After being inspired by her Tech Trek experience, Jocelyn wanted to see hospital devices in the ICU. So Drew arranged with Sierra Nevada Memorial Hospital’s VP and Chief Nursing Officer, Monica Biley, for a tour of the ICU.
The ICU tour was led by Clinical Education Coordinator Melayn Dryden. The nurses responsible for watching the monitor and responding to heart monitor alarms provided an excellent overview of how they handle the problem of alarm fatigue to keep patients safe.
One nurse explained how important it is to be able to see patients from the central monitor station.
The 10-bed ICU at Sierra Nevada Memorial Hospital is designed in a U-shape around the central station with windows so that patients are in full view.
That way, when a patient does an activity like brushing their teeth that causes motion artifact simulating an abnormal heart rhythm on the electrocardiogram, the nurse can immediately identify that this is a false alarm and that no treatment is necessary.
As Drew and Jocelyn left the hospital, Jocelyn remarked with a big smile on her face, “That was really fun!”
Source: Barbara Drew
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