Florida Hospital Tests Safety Bundle to Improve Alarm Management

By Jonathan Springston, Editor, Relias Media

Nurses working on a surgical ICU in a Florida hospital boosted their alarm management practices using a unique five-step education tool.

Staff started with a survey of all nurses on the unit to determine current emergency alarm response techniques and to gauge possible alarm fatigue. From there, researchers introduced the CEASE bundle (communication, electrodes, appropriateness, setup, and education).

Nurses learned about the bundle during regular meetings and through several training sessions. Information about the bundle was placed around the unit for reference.

Through observation and a post-intervention survey, it seems many nurses liked the new bundle. Many reported missing fewer alarms, that they were more sensitive to alarms overall and responded faster to each, and that the tool simplified alarm parameters. Overall, 82% of post-intervention survey respondents reported the bundle alleviated their alarm fatigue.

"Clinical alarms are important, but they also contribute to a noisy hospital environment for patients and clinicians. With high sensitivity and low specificity, monitors can generate an overwhelming number of alarms, many of which are false or nonactionable alerts," said lead author Stephanie Bosma, DNP, APRN, FNP-BC, an advanced practice nurse practitioner at the hospital. "Our project gave alarm management skills much-needed attention and introduced a new tool to help staff maximize the benefits of clinical alarms."

As part of its 2023 National Patient Safety Goals, The Joint Commission (TJC) has made alleviating patient harm associated with alarms a priority. “There is general agreement that this is an important safety issue. Universal solutions have yet to be identified, but it is important for a hospital to understand its own situation and to develop a systematic, coordinated approach to clinical alarm system management,” TJC explained in January. “Standardization contributes to safe alarm system management, but it is recognized that solutions may have to be customized for specific clinical units, groups of patients, or individual patients.”

For more on this and other related subjects, be sure to read the latest issues of Critical Care Alert, ED Management, Emergency Medicine Reports, and Healthcare Risk Management.