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Hospital Alarms Torment Patients

As alarms proliferate, overwhelmed hospital staff may overlook real signs of harm.

When Kea Turner’s 74-year-old grandmother checked into Virginia’s Sentara Virginia Beach General Hospital with advanced lung cancer, she landed in the oncology unit where every patient was monitored by a bed alarm.

“Even if she would slightly roll over, it would go off,” Turner said. Small movements ― such as reaching for a tissue ― would set off the alarm, as well. The beeping would go on for up to 10 minutes, Turner said, until a nurse arrived to shut it off.

Tens of thousands of alarms shriek, beep and buzz every day in every U.S. hospital. All sound urgent, but few require immediate attention or get it.

Intended to keep patients safe alerting nurses to potential problems, they also create a riot of disturbances for patients trying to heal and get some rest.

Nearly every machine in a hospital is now outfitted with an alarm ― infusion pumps, ventilators, bedside monitors tracking blood pressure, heart activity and a drop in oxygen in the blood. Even beds are alarmed to detect movement that might portend a fall. The glut of noise means that the medical staff is less likely to respond.

Alarms have ranked as one of the top 10 health technological hazards every year since 2007, according to the research firm ECRI Institute. That could mean staffs were too swamped with alarms to notice a patient in distress, or that the alarms were misconfigured. The Joint Commission, which accredits hospitals, warned the nation about the “frequent and persistent” problem of alarm safety in 2013. It now requires hospitals to create formal processes to tackle alarm system safety, but there is no national data on whether progress has been made in reducing the prevalence of false and unnecessary alarms.

The commission has estimated that of the thousands of alarms going off throughout a hospital every day, an estimated 85% to 99% do not require clinical intervention.

Staff, facing widespread “alarm fatigue,” can miss critical alerts, leading to patient deaths. Patients may get anxious about fluctuations in heart rate or blood pressure that are perfectly normal, the commission said.

And bed alarms, a recent arrival, can lead to immobility and dangerous loss of muscle mass when patients are terrified that any movement will set off the bleeps.

An ‘Epidemic Of Immobility’

In the past 30 years, the number of medical devices that generate alarms has risen from about 10 to nearly 40, said Priyanka Shah, a senior project engineer at ECRI Institute. A breathing ventilator alone can emit 30 to 40 different noises, she said.

In addition to triggering bed alarms, patients who move in bed may set off false alarms from pulse oximeters, which measure the oxygen in a patient’s blood, or carbon dioxide monitors, which measure the level of the gas in someone’s breath, she said.

Shah said she has seen hospitals reduce unneeded alarms, but doing so is “a constant work in progress.”

Many nursing home residents suffer from AD and are at an increased risk of falling. Are some of these residents individuals that you provide care for on a daily basis? The answer is probably yes. Prevention of falls, whether causing injury or not, is a key safety issue in nursing homes.

For many years, it was assumed that falls were unavoidable accidents, due to just being old, and that nothing, apart from restricting a resident’s mobility or placing them in physical restraints, could be done to prevent falls. Over the past several years, however, interest in fall prevention flourished and, as a result, our thinking about falls has dramatically changed. We now have a better understanding of why falls occur and, more importantly, what can be done to prevent falls from happening.   

Pedagogy author Dr. Tideiksaar is a gerontologist, which is a health care professional who specializes in working with elderly patients, and a geriatric physician's assistant. He has been active in the area of fall prevention for over thirty years. He has directed numerous research projects on falls and has developed fall prevention programs in the community, assisted living, home care, acute care, and nursing facility settings. He has as authored several books devoted to the topic of fall prevention.  

To see a complete listing of our Fall Prevention courses and more CLICK HERE.

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