The AAMI Foundation recently published a new white paper as part of its HTSI Safety Innovations series that explores alarm management strategies from a military perspective. According to Daniel McFarlane, Sc.D. of Lockheed Martin Advanced Technology Laboratories, the approaches being used across hospital settings continue to present similar challenges: ignored alarm signals because of fatigue, lengthy practitioner response rates to alarms, and provider confusion over which alarms are important.
“The lack of actionable intelligence from alarm signals makes it impossible for nurses to effectively triage their multitasking among multiple patients,” noted Dr. McFarlane. “Each alarm feature considers only local conditions on separate sensors on separate instruments for separate patients. The result is an overwhelming rate of alarm signals from multiple devices associated with multiple patients that do not carry the context of information needed for nurses to understand the signals relative to their responsibility to triage their efforts.”

There are 9 types of clinical context facilitated by an advanced alarm management platform that work together with advanced rules to reduce alarm fatigue and increase situational awareness:

1. Alarm Context: supplemental data delivered with an alarm or event notification; e.g. multiple data points including blood pressure, respiratory rate, and SpO2. 2. Patient Context: supplemental data about the patient derived from a real-time interface to ADT or an EMR. 3. Location Context: leverages RTLS or RFID to determine the availability of a person or equipment. 4. Proximity Context: locates the closest nurse capable of responding to an event. 5. Presence Context: refers to the status of a nurse’s communication device and whether the phone can receive a call or message. 6. Busy Context: advanced rules enable predetermined conditions to automatically set a nurse’s status to “not available; e.g. two life critical alarms are delivered to the same nurse over 5 minutes time. 7. Preference Context: enables nurses to determine how they would like to be notified of an event; e.g. a night nurse may opt for vibrate annunciation rather than an audible alarm to avoid disturbing a sleeping patient. 8. Cognitive Load Context: may be derived through the dynamic rules engine and its ability to accumulate the number and complexity of accepted tasks and assignments throughout a 12-hour shift, and determines the most appropriate clinician to allocate an alarm to. 9. Care Team Context: refers to when, as part of the response workflow and resulting communications, the alarm safety system can dynamically generate the list of care team members for each alarm or alarm class, and specific to each patient, which eliminates manual searching for the desired contact.

Hospitals must make a paradigm shift from single-use point of care solutions, to a more comprehensive enterprise approach designed to solve multiple pain points. An advanced alarm management platform unifies communications and actionable events across multiple departments by facilitating clinical integration and delivering context to foster situational awareness.