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Alarm Fatigue

Alarm Fatigue has been recognized by the medical industry as a top hazard that has and does contribute to negative patient outcomes including death. ECRI has listed medical alarms in their top 10 medical device hazards for the past three years and it has been listed as the #1 risk the last two years. The Joint Commission (TJC) has issued a Sentinel Event Alert on Medical Device Alarms and has established the safety of clinical alarm systems as a national patient safety goal for 2014 and 2016. The AAMI conducted the Medical Device Alarm Summit in November 2011, and continues to work on this issue via their Medical Alarm Steering Committee, which is proposing new clinical research to provide guidance to the health care industry on default settings for some of these devices.

The CD-BIO team in partnership with National Patient Care Services formed the Alarm Fatigue Work Group, and held the first Kaiser Permanente Alarm Summit in November 2012. This multidisciplinary and inter-regional team developed a plan for alarm reduction. The group has focused on physiological alarms in the inpatient adult telemetry areas as a top priority and created a four step program for implementation based on clinical literature and recommendations from ECRI, AAMI and TJC.

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