- Source: Alarm fatigue
- Alarm fatigue
- False alarm
- Boiling frog
- 2023 Hawaii wildfires
- Alarm management
- Nurse call button
- Information overload
- Manual fire alarm activation
- Health technology
- Critical care nursing
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Alarm fatigue or alert fatigue describes how busy workers (in the case of health care, clinicians) become desensitized to safety alerts, and as a result ignore or fail to respond appropriately to such warnings. Alarm fatigue occurs in many fields, including construction and mining (where vehicle back-up alarms sound so frequently that they often become senseless background noise), healthcare (where electronic monitors tracking clinical information such as vital signs and blood glucose sound alarms so frequently, and often for such minor reasons, that they lose the urgency and attention-grabbing power which they are intended to have), and the nuclear power field. Like crying wolf, such false alarms rob the critical alarms of the importance they deserve. Alarm management and policy are critical to prevent alarm fatigue.
Healthcare
The constant sounds of alarms and noises from blood pressure machines, ventilators and heart monitors causes a "tuning out" of the sounds due to the brain adjusting to stimulation. This issue is present in hospitals, in home care providers, nursing homes and other medical facilities alike. The US Food and Drug Administration cataloged 566 deaths from ignored alarms in the period 2005 to 2008. The United States-based Joint Commission's sentinel event reports 80 alarm-related deaths and 13 alarm-related serious injuries over the course of a few years. On April 18, 2013, the Joint Commission issued a sentinel event alert that highlighted the widespread problem of alarm fatigue in hospitals. Their recommendations included establishing guidelines to tailor alarm settings, training all members of the clinical team on safe use of alarms, and sharing information about alarm-related incidents. This alert resulted in designation in 2014 of clinical alarm system safety as a National Patient Safety Goal and it remains a goal in 2017. This Goal will force hospitals to establish alarm safety as a priority, identify the most important alarms, and establish policies to manage alarms by January 2016. ECRI Institute has listed alarms on its "Top Ten Hazards List" since 2007; in 2014, alarms were listed as the number one hazard.
= Unintended outcomes of alarms
=The large number of alarms, especially of false alarms, has led to several unintended outcomes. Some consequences are disruption in patient care, desensitization to alarms, anxiety in hospital staff and patients, sleep deprivation and depressed immune systems, misuse of monitor equipment including "work-arounds" such as turning down alarm volumes or adjusting device settings, and missed critical events. Some additional outcomes include workload increase, interference with communication, wasted time, patient dissatisfaction, and unnecessary investigations, referrals, or treatments.
= Solutions
=There are many solutions proposed to reduce alarm fatigue in healthcare settings:
Change alarm sounds to be softer and friendlier in order to improve identification of alarms by sound alone. Another recommendation is for clinicians to adjust the parameters and delays to alarms to match the patient's traits and status. However, this directly trades sensitivity for specificity.
Use centralized alarms. In this approach, alarms do not fire at the bedside, but fire at a central monitoring station where a trained healthcare provider evaluates each alarm and alerts the bedside clinician if they should intervene or evaluate the patient.
Adjust alarm algorithms. Currently, the alarm systems are very sensitive but not specific. This leads to a large amount of false alarms. The algorithms used can be adjusted to balance between sensitivity and specificity to limit the number of false alarms and still detect true deterioration.
Child abduction
The amber alert system used in countries such as the United States and Canada to notify the public of a child abduction has been theorized as being susceptible to alarm fatigue. A 2018 abduction in Thunder Bay resulted in an amber alert being sent to cell phones as far away as Ottawa, some 15 hours' drive from Thunder Bay, followed one hour later by a second alert which notified individuals that the first alert had been resolved. A similar double alert occurred on a single night in February 2019, leading to concerns over alert fatigue.
Public transport
In the New York City Subway, the Metropolitan Transportation Authority installed sirens in 2006 to discourage subway users from using emergency exits to evade fares; the sirens had little effect other than irritating passengers and were removed in 2015.
Alarm fatigue has sometimes contributed to public transport disasters such as the 2009 train collision in Washington, DC, caused by a faulty track circuit which failed to detect the presence of a stopped train. Though the automatic train control system generated alerts notifying train dispatchers to the presence of such faulty circuits, the rate of such alerts was about 8,000 per week. An investigation by the US National Transportation Safety Board concluded that "the extremely high incidence of track-circuit alarms would have thoroughly desensitized [the dispatchers]".
Weather
Some people think the large number of deaths from Hurricane Ida in New York and New Jersey may have been the result of too many warnings. Since 2012, weather alerts have been sent out to cell phones, but in 2020, federal officials set up a three-tier system so people would get this warning for the most serious situations.
Warning Labels
California Proposition 65 has been criticized for causing "over-warning" due to encouraging "meaningless warnings." There is no penalty for posting an unnecessary warning sign, and to the extent that warnings are vague or overused, they may not communicate much information to the end user. Many companies now routinely attach Prop 65 warning labels to any product of theirs that they think might possibly contain one of the 900 listed chemicals without testing to see whether the chemical is really present in their product and without reformulating their product, because it is cheaper to do so than to run the risk of being sued by Prop 65 enforcers.
See also
Alarm management – Usability factor in alarm systems
Banner blindness – Tendency to ignore banner-size notices
Compassion fatigue – Condition characterized by emotional and physical exhaustion
False alarm – Deceptive or erroneous report of an emergency
Habituation – Decrease in a behavioral response to a repeated stimulus
Inattentional blindness – Condition of failing to see something in plain view
Information overload – Decision making with too much information
Normalization of deviance – Sociological phenomenon
Semantic satiation – Psychological phenomenon
References
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Artikel Terkait "alarm fatigue"
Alarm Fatigue - Making Healthcare Safer III: A Critical Analysis of ...
Alarm fatigue occurs when clinicians experience high exposure to medical device alarms, causing alarm desensitization and leading to missed alarms or delayed response. As the frequency of alarms used in healthcare rises, alarm fatigue has been increasingly recognized as an important patient safety issue.
Alarm Fatigue is Way Too Real (and Scary) For Nurses
15 Nov 2022 · The American Association of Critical Care Nurses defines alarm fatigue as a sensory overload that occurs when clinicians are exposed to an excessive number of alarms, which can result in desensitization to alarm sounds and an increased rate of missed alarms.
Alarm fatigue - Wikipedia
Alarm fatigue or alert fatigue describes how busy workers (in the case of health care, clinicians) become desensitized to safety alerts, and as a result ignore or fail to respond appropriately to such warnings. [1]
Alarm fatigue: a patient safety concern - PubMed
Alarm fatigue is sensory overload when clinicians are exposed to an excessive number of alarms, which can result in desensitization to alarms and missed alarms. Patient deaths have been attributed to alarm fatigue.
Alarm fatigue a top patient safety hazard - PMC - PubMed …
Caregivers with “alarm fatigue” are more likely to ignore or have trouble distinguishing between alarms, which can lead to delayed treatment and patient harm, the US Food and Drug Administration cites a report indicating there were 566 alarm-related deaths between 2005 …
Reducing the Safety Hazards of Monitor Alert and Alarm Fatigue
01 Mei 2016 · Alarm fatigue occurs when busy workers are exposed to numerous frequent safety alerts and as a result become desensitized to them. This desensitization can lead to longer response times or to missing important alarms.
Alarm fatigue: its significance and ways to address it - Philips
05 Feb 2023 · In the dynamic landscape of healthcare leadership, one can’t ignore the pervasive challenge of alarm fatigue, a silent threat that jeopardizes patient safety and that strains the resilience of our healthcare providers.
Alarm Fatigue: Causes and Effects - PubMed
The term "Alarm fatigue" is commonly used to describe the effect which a high number of alarms can have on caregivers: Frequent alarms, many of which are avoidable, can lead to inadequate responses, severely impacting patient safety.
Determinants of Medical Equipment Alarm Fatigue in Practicing …
Medical equipment alarm fatigue refers to a phenomenon where medical personnel who are exposed to alarms from multiple medical equipment for a long time become less sensitive to these alarms, resulting in the potential for them to ignore critical equipment alarms.
13. Alarm Fatigue
Alarm fatigue occurs when clinicians experience high exposure to medical device alarms, causing alarm desensitization and leading to missed alarms or delayed response. As the frequency of alarms used in healthcare rises, alarm fatigue has been increasingly recognized as an important patient safety issue.