Excessive Non-actionable Hospital Alarms Lead to Alarm Desensitization [Interview][Transcript]

Connie_Dills_Acute_careGuest: Connie Dills
Presenter: Neal Howard
Guest Bio: Experienced Registered Respiratory Therapist with a broad background of experience in the areas of clinical practice, management & education. At The Hospital for Special Care, New Britain, CT 2001-present Respiratory Practice Manager – Respiratory Care Services 2014-present Clinical Educator.

Segment overview: Connie Dills, MBA, RRT, RPFT, Respiratory Practice Manager at the Hospital for Special Care in Connecticut discusses the blaring distractions and fatigue nuisance alarms caused her nurses and patients.


Health Professional Radio – Non-actionable Hospital Alarms

Neal Howard: Hello and welcome to Health Professional Radio. I’m your host Neal Howard, so glad that you could join us today. We’ve all been to the hospital and seen and/or heard bells, the whistle, the buzzers, the various alarms that led health practitioners know when there is a problem or let them know that there is no problem at all. Our guest in studio today is Connie Dills. She is Respiratory Practice Manager at the Hospital for Special Care in Connecticut. And she is here today to discuss these alarms and how important it is for our healthcare professionals not to become desensitize by false or non-actionable alarms. How are you doing today Connie?

Connie Dills: I’m doing very well thank you. How are you?

N: I’m doing well. You are the hospitals respiratory practice manager, now could you tell us a little bit about what it is that the Hospital for Special Care is involved in?

C: Well Hospital for Special Care is a 228 bed that’s classified as a Long Term Acute Care hospital, “LTAC” as many have heard that term before.

N: Uh huh.

C: But we have, we’re nationally recognized for advance care for rehab patients, pulmonary, acquired brain injured patients, patients with spinal cord injury, medically complex, neurovascular disorders, cardiac disease, pediatrics to adults, everything in between.

N: So you’re a full service facility basically?

C: Pretty much, yes. I mean our patients are much acuter than what most people heard to know as a long term care facility. Our patient are coming out of the acute care facilities much more quickly. Now they are much sicker, far more acute so the care that we provide is pretty high level.

N: Now 228 beds at your facility, that’s a lot of patients, a lot of alarms. I was talking earlier about non-actionable hospital alarms, those for lack of a better term false alarms or an alarm that doesn’t need as much attention as maybe another type of alarm. Can’t that give confusing and tiring and downright dangerous?

C: Well it can be. And out of our 228 beds, we have about a 100 of those beds, a 100 of those patients are on mechanical ventilation, and so like support equipment. And you’re absolutely right, there are tremendous number of alarms that go off, even with just the ventilator that doesn’t include IV’s, or feeding pumps, or bed alarms, pulse oximeters, all the other equipment that patients are connected to.

N: Now talk a little bit about some of the downside of being at the hospital or special care and the alarms, they’re doing what they’re supposed to do. But your only one person with a couple of hands. What types of steps do you take in order to keep themselves on track and keep yourself safe?

C: Right. Well with our high volume of patients on mechanical ventilation, we do have quite a large respiratory staff here. Staff of about 96 total, respiratory therapists and that manage all of this ventilators. And it is challenging given the fact that the way some of the units are laid out, the patients are in the ICU type setting where you can see them all at once and kind of monitor them visually as well. So it’s extra layer of challenge there in trying to manage these ventilators when there everyone’s not in plain sight.

N: I’m familiar with triage, that’s where you place a priority of one injury over another. Is it the same type of process when an alarm goes off, maybe something is indicated at the nurse’s station, maybe it’s a real emergency there are two lights, if it’s not that big of a deal maybe there is one, I’m not sure how it works when alarms are heard.

C: What we have here at Hospital for Special Care is a system called “Bernoulli” made by Cardiopulmonary Corporation and it’s an alarm monitoring system. And what it is allowed us to do is even though the device itself will alarm for every alarm condition that can possibly occur, what it allows us to do is to filter out some of those alarms that maybe transient, may not require immediate action, and the practitioners are alerted via a different audible alarm, a visual monitored alarm. And they also receive a page on their pager that tells them exactly which patient, what room, what the alarm condition is and they know that that’s a critical alarm that they need to respond to immediately.

N: Now you mentioned that you have upwards of 90 practitioners there at the facility all doing whatever it is that they need to do. And in addition to their normal duties and processes, they’re monitoring and managing the alarms and the severity of those alarms. Does that staffing number based on what you started with or is it a result of putting in this new system, this better system? Has it reduce your staffing down to 90 or is there some staffing reduction in that area yet to take place?

C: Well we really over the years we have actualized a little bit of a decrease in not significantly in our staff. What has been done is actually allows the respiratory therapist to provide the other aspects of their care a little bit more thoroughly rather than constantly answering alarms. We estimated that we have probably about an 80% reduction in the number of alarms that they have to respond to. So therefore they’re able to provide the other aspects of the respiratory care to the patient.

N: Now as we wrap up Connie, before this Bernoulli system was implemented into your facility how did you handle non-actionable hospital alarms?

C: They did have to stop what they were doing frequently to respond to these alarms or call out to a co-worker and have them check on the patients and that sort of thing. I think by virtue of the fact that volume of alarms that go off I think that as a natural occurrence for people to be somewhat desensitized. But I think now with the Bernoulli System they really are tuned in when they hear Bernoulli go off, they know immediately that they have to respond directly to the patient. If other vent alarms go off that escalates, that aren’t actionable initially, they will escalate and ultimately result in actionable alarm that will prompt Bernoulli to alert them.

N: You’ve been listening to Health Professional Radio, I’m your host Neal Howard. We’ve been in studio today talking with Connie Dills, experienced Registered Respiratory Therapist in all areas of clinical practice, management and education as well. She is the Respiratory Practice Manager the Hospital for Special Care in Connecticut and we’ve been here talking about non-actionable or false alarms – not necessarily a false alarm, but just an alarm that doesn’t require the attention that another alarm might require. Transcript and audio of this program are available at healthprofessionalradio.com.au and also at hpr.com and you can subscribe to our podcast on iTunes.

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