Nurse! what's taking so long?

April 11, 2017 by Randy Dotinga, Healthday Reporter

(HealthDay)—When a bedside alarm goes off in a child's hospital room, anxious parents expect nurses to respond pronto.

That rarely happens, however, and a new study helps explain why.

Researchers found that nurses are usually quick to react when alarms are urgent. But, they're slower to respond at the end of the workday or when they suffer from "chronic alarm fatigue."

Also, having parents present doubled the time on average, the study found.

But, delayed response time didn't threaten any of the 100 evaluated in the study, the researchers said. And just half of 1 percent of more than 11,000 alarms analyzed were deemed "actionable," or crucial.

"The nurses were overall doing a great job predicting which alarms were going to be important," said study lead author Dr. Christopher Bonafide, an assistant professor of pediatrics with the Children's Hospital of Philadelphia. "Their intuition was correct."

The high number of false alarms in U.S. hospitals has led to "alarm fatigue" among nurses. As a result, the Joint Commission—the organization that accredits American hospitals—issued new guidelines for managing alarm monitors.

The beeps and buzzes alert staff to medical problems facing patients such as high heart rates, dips in oxygen levels in the blood and dangerous heartbeat patterns, Bonafide said.

But, many false alarms are caused simply by babies moving around and disrupting sensors, he said.

"When an alarm goes off and the nurse is already in the patient's room, they can immediately look up, check on the patient, and make sure everything is OK," Bonafide said. "When a nurse isn't in the room, some hospitals like ours have the ability to send them a text message to the phone that they are carrying."

For this study, researchers analyzed video of 38 nurses caring for 100 patients at Children's Hospital of Philadelphia from 2014-2015.

Almost all of the 11,745 beeps and buzzes that sounded were valid. And 50 were deemed critical, "the important ones we would not want anyone to miss," Bonafide said. Nurses responded in about a minute, on average, to these alarms.

However, overall, half of the total alarms took 10.4 minutes or more to address, the study found.

Years on the job and caseload accounted for some differences in response time.

"Nurses with under one year of experience responded faster than nurses with one or more years' experience," Bonafide said. "Nurses taking care of just one patient responded faster than those caring for more than one patient. And for each hour that passed in a 's shift, their response time got a little bit slower."

Other factors appeared to contribute, too.

"If family members were absent from the bedside, response time was faster than if parents were there," he said. The median was six minutes when family members weren't there, and 12 minutes when they were.

Also, "more complex" patients got faster responses, Bonafide said. "And patients who had prior alarms that required interventions to be taken got faster responses than those who had not had those experiences."

Marjorie Funk, a professor at Yale University School of Nursing, praised the study. She said the findings shouldn't worry parents about leaving their child's side at hospitals.

"Alarms for serious events sound different, and nurses respond immediately," Funk noted. "Other alarms may require their attention, but they can finish what they are doing for another patient before responding or can ask a colleague to respond."

Bonafide said there are no guidelines that tell nurses how quickly they should response to various alarms. But, he thinks the system needs improvement.

"There's quite a lot we can do to improve the safety and performance of these systems and make them work for us and provide truly useful information that helps nurses identify patients who are getting into trouble," he said.

When a child is hospitalized, Bonafide and Funk agreed that it's appropriate for parents to ask questions. These might include asking physicians and nurses, "Why is my child being continuously monitored? What problems are you looking for?" and "What should I do if an alarm goes off?"

The study appears in the April 10 issue of JAMA Pediatrics.

Explore further: Hospital alarms blend together, fail to alert caregivers of emergencies

More information: Christopher Bonafide, M.D., assistant professor, pediatrics, Children's Hospital of Philadelphia; Marjorie Funk, Ph.D., RN, professor, nursing, Yale University School of Nursing, New Haven, Conn.; April 10, 2017, JAMA Pediatrics.

For more about helping your child tolerate a hospital visit, see the University of Rochester Medical Center.

Related Stories

Hospital alarms blend together, fail to alert caregivers of emergencies

March 17, 2017
The failure of hospital caregivers to respond to medical alerts is often attributed to "alarm fatigue"—the idea that nurses or doctors can become desensitized to the nonstop cacophony of beeps that patient-monitoring devices ...

Rethinking hospital alarms

May 27, 2016
Hospital alarms are currently ranked as the "top medical technology hazard" within the United States. On average, there are about 480,000 patients in hospitals—each generating about 135 clinical alarms per day. But studies ...

Hospital group says 'alarm fatigue' can be deadly

April 8, 2013
(AP)—Constantly beeping alarms in hospitals are being linked to patient deaths and other dangers in a new alert from the Joint Commission.

New vital sign monitoring system may improve care for hospitalized patients

November 6, 2015
A recent study indicates that a newly designed vital sign monitoring system can improve patient safety in medical and surgical units without an abundance of unnecessary alarms.

Modern monitoring systems contribute to alarm fatigue in hospitals

December 4, 2014
Jessica Zègre-Hemsey, a cardiac monitoring expert at the University of North Carolina at Chapel Hill, and her colleagues at the University of California San Francisco, revealed more than 2.5 million alarms were triggered ...

Boston Medical Center alleviates alarm fatigue by decreasing noise

January 15, 2014
Boston Medical Center (BMC) successfully reduced audible alarms as a way to combat alarm fatigue and improve patient safety. The hospital, one of two in the country that spearheaded this issue, implemented a novel cost-effective ...

Recommended for you

Male contraceptive compound stops sperm without affecting hormones

April 20, 2018
A new study published today in the journal PLOS ONE details how a compound called EP055 binds to sperm proteins to significantly slow the overall mobility of the sperm without affecting hormones, making EP055 a potential ...

A dose of empathy may support patients in pain

April 20, 2018
Research published in the Journal of the Royal Society of Medicine suggests that empathic, positive messages from doctors may be of small benefit to patients suffering from pain, and improve their satisfaction about the care ...

New research suggests possible link between sudden infant death syndrome and air pollution

April 20, 2018
A study led by the University of Birmingham suggests a possible association between exposure to certain pollutants and an increased risk of so-called 'cot death'.

For heavy lifting, use exoskeletons with caution

April 20, 2018
You can wear an exoskeleton, but it won't turn you into a superhero.

New device to help patients with rare disease access life-saving treatment

April 19, 2018
Patients with a rare medical condition can receive life-saving treatment at the touch of a button thanks to a new device developed by scientists.

Low-cost anti-hookworm drug boosts female farmers' physical fitness

April 19, 2018
Impoverished female farm workers infected with intestinal parasites known as hookworms saw significant improvements in physical fitness when they were treated with a low-cost deworming drug. The benefits were seen even in ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.