Combatting Alarm Fatigue: Strategies for Optimizing Your Telemetry Monitoring Implementation

Telemetry monitors are patient-worn devices that allow the patient's heart rate, heart rhythm, and other physiologic conditions to be assessed without restricting the patient to a bed. These devices allow cardiac patients to move around the facility while still being monitored. Monitors are designed to transmit an alarm signal to nursing staff if the patient develops a concerning heart rhythm or other condition that requires attention. The safety and effectiveness of a telemetry monitoring program depends heavily on the organization's alarm management strategy. Any failure to recognize or delay in responding to a potentially life-threatening change in the patient's condition could lead to severe harm.

As with any physiologic monitoring system, healthcare organizations must scrutinize all aspects of how telemetry alarms are initiated, how they are communicated, and how staff respond. The use of inappropriate alarm settings or notification processes can prevent staff from learning about a change in the patient's condition or may lead to frequent false alarms or nuisance alarms that overwhelm, distract, or desensitize staff—a phenomenon known as alarm fatigue. Either situation can result in valid alarm conditions being missed by staff, and thus a patient's deterioration going unnoticed.

Improvements in the way that telemetry systems are implemented and managed can help combat alarm fatigue and reduce the risk of alarm-related adverse events.

Learning Objectives

During this lab webcast, we will discuss:

• Alarm fatigue: what it is, why it is a concern, and how telemetry implementation decisions can contribute to this hazard
• Criteria for selecting patients for telemetry monitoring
• Policies and procedures for setting and disabling alarms
• Alarm escalation processes and secondary alarm notification systems
• Strategies to optimize the monitor watching function

Priyanka Shah, MS

Senior Project Officer, ECRI

Priyanka Shah is a senior project officer with the Device Evaluation group at ECRI, where she performs medical device evaluations, investigates system failures, develops practical guidance for healthcare facilities, conducts accident investigations, and consults healthcare facilities on prepurchase selection and appropriate use of medical equipment and health-IT systems. Her areas of expertise include consumer devices, remote patient monitoring, physiologic patient monitoring, alarm management, and EHR usability. Ms. Shah came to ECRI with a background in research engineering and program management. She earned her MS in Biomedical Engineering from Purdue University.

Marc Schlessinger

Senior Consultant & Investigator, Healthcare Incident Investigation & Technology Consulting, ECRI

Marc Schlessinger is an experienced healthcare administrator with a strong clinical skill set, having been responsible for ancillary service operations in hospitals for over 30 years. As a Senior Consultant, Marc provides consulting services and assistance to hospitals and other healthcare institutions in matters concerning technology, strategic planning, operations, and reimbursement. He has been a practicing Registered Respiratory Therapist since 1978.

Rob Schluth

Principal Project Officer 1, Device Evaluation, ECRI

Rob Schluth is a project leader focusing on content development and program management for ECRI's Device Evaluation group. During his 25 years at ECRI, Rob has contributed to hundreds of the organization's device evaluations, problem reports, and guidance articles spanning a wide range of health technologies. Rob currently manages special initiatives for the Device Evaluation team and leads the development of the organization's annual Top 10 Health Technology Hazards report.