Cincinnati Children’s Hospital Reduces Alarm Fatigue, Increases Caregiver Compliance

The sound of monitor alarms in hospitals can save patients’ lives, but the frequency with which the monitors go off can also lead to “alarm fatigue,” in which caregivers become desensitized to the ubiquitous beeping.

Researchers at Cincinnati Children’s Hospital Medical Center have tackled this problem and developed a standardized, team-based approach to reducing cardiac monitor alarms. The process reduced the median number of daily cardiac alarms from 180 to 40, and increased caregiver compliance with the process from 38 percent to 95 percent.

“Cardiac monitors constitute the majority of alarms throughout the hospital,” says Christopher Dandoy, MD, a physician in the Cancer and Blood Diseases Institute at Cincinnati Children’s and lead author of the study. “We think our approach to reducing monitor alarms can serve as a model for other hospitals throughout the country.”

The main accrediting body for healthcare organizations and programs, The Joint Commission, reported 80 alarm-related deaths between January 2009 and June 2012.

Dr. Dandoy’s study of this project will be published Nov. 10 in the eFirst pages of the journal Pediatrics.

The researchers developed a standardized cardiac monitor care process on the 24-bed, pediatric bone marrow transplant unit at Cincinnati Children’s. The project involved a process for initial ordering of monitor parameters based on age-appropriate standards, daily replacement of electrodes in a manner that was pain-free for patients, individualized daily assessment of cardiac monitor parameters, and a reliable method for appropriate discontinuation of the monitors.

“With fewer false alarms, the staff can address significant alarms more promptly,” says Dr. Dandoy. “We believe the roles and responsibilities entailed in this process can be applied to most units with cardiac monitor care.”

Dr. Dandoy designed and conducted the study along with colleagues in the Cancer and Blood Diseases Institute and in the James M. Anderson Center for Health Systems Excellence at Cincinnati Children’s.