The Joint Commission has previously addressed the issue of alarms with a Sentinel Event Alert in 2013 and most recently with a 2014 update to the NPSG, previously in effect in 2003 and 2004. The second phase of implementing this updated NPSG begins on January 1, 2016, by which time healthcare organizations must apply policies and procedures on alarm management to ensure alarm solutions are in place and are functioning. The NPSG also requires that healthcare organizations educate their staff and licensed independent practitioners on the purpose and the correct operation of their current alarm systems.
In 2014, organizations established alarm system safety as an organizational priority, identifying and prioritizing alarm signals that are most important to manage. With the second phase of the compliance approaching, some hospitals are faring better than others, says JoAnne Phillips, MSN, RN, CPPS, Manager of Quality and Patient Safety Penn Care at Home, who has twelve years of alarm management experience under her belt.
“While some hospitals are forerunners, others are struggling a little and are further behind than I thought they would be," Phillips states.
Clinical alarms are in place to alert and activate staff to high-risk situations; however, they aren’t without their caveats. Technical hospital environments house an overwhelming number of alarming devices – and more doesn’t always equate to better.
Compromises in the process result in desensitization, alarm fatigue, decreased patient and staff satisfaction and ultimately a gap in patient safety. “Assessing risk means identifying the most important alarms to manage. If an alarm isn’t attended to or if it malfunctions, that creates risk for patients,” states Carr; improving patient safety is at the heart of The Joint Commission’s NPSGs.
Physiological alarms are a bulky issue for organizations to wrap their arms around; identifying current alarm systems, running diagnostics and successfully extracting data can be a daunting job, and hospitals have reported difficulties “retrieving data from alarms; sometimes it has to be a manual process,” states Maureen Carr, Project Director in the Department of Standards and Survey Methods at The Joint Commission, and data can’t drive clinical change when it’s inaccessible.
“Part of process improvement is being able to measure your successes and that’s hard to do when people aren’t understanding the breadth of the problem – such as where they get their data from,” says JoAnne Phillips.