Electrocardiographic Alarms in the Acute Care Setting

Abstract

Electrocardiographic [ECG] alarms are used in acute care settings to continuously monitor patients’ cardiac status, and to alert clinicians to potentially life-threatening changes in a patient’s condition. However, the numbers of alarms in the acute care setting have increased exponentially in the past 20 years. This was to ensure patient safety, and to avoid adverse events that could end in litigations [1]. Cardiac alarms represent the second most frequent alarm in the acute care setting at 37% [2]. Although ECG alarms may help save lives, proper alarm management has been problematic and ECG alarms that were designed to enhance patient safety have become a top national safety hazard. Registered Nurses [RNs] must respond to a variety of alarms in acute care settings; however many of these alarms require no action because they may not be triggered by an actual health need. Responding to non-actionable alarms can interrupt nursing workflow, increase the likelihood of clinical errors, and can lead to alarm fatigue and nurse burnout, as well as serious financial consequences for the organizations. This paper discusses problems with ECG alarm management as experienced by RN’s, and provides suggestions to improve alarm management in acute care settings.