Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2023.07.013
Brazilian Journal of Anesthesiology
Original investigation

Decreasing inconsistent alarms notifications: a pragmatic clinical trial in a post-anesthesia care unit

Saullo Queiroz Silveira, Rafael Sousa Fava Nersessian, Arthur de Campos Vieira Abib, Leonardo Barbosa Santos, Fernando Nardy Bellicieri, Karen Kato Botelho, Helidea de Oliveira Lima, Renata Mazzoni de Queiroz, Gabriel Silva dos Anjos, Hermann dos Santos Fernandes, Glenio B. Mizubuti, Joaquim Edson Vieira, Leopoldo Muniz da Silva

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Abstract

Background

Alarms alert healthcare professionals of deviations from normal/physiologic status. However, alarm fatigue may occur when their high pitch and diversity overwhelm clinicians, possibly leading to alarms being disabled, paused, and/or ignored. We aimed to determine whether a staff educational program on customizing alarm settings of bedside monitors may decrease inconsistent alarms in the Post-Anesthesia Care Unit (PACU).

Methods

This is a prospective, analytic, quantitative, pragmatic, open-label, single-arm study. The outcome was evaluated on PACU admission before (P1) and after (P2) the implementation of the educational program. The heart rate, blood pressure, and oxygen saturation alarms were selected for clinical consistency.

Results

A total of 260 patients were included and 344 clinical alarms collected, with 270 (78.4%) before (P1), and 74 (21.6%) after (P2) the intervention. Among the 270 alarms in P1, 45.2% were inconsistent (i.e., false alarms), compared to 9.4% of the 74 in P2. Patients with consistent alarms occurred in 30% in the P1 and 27% in the P2 (p = 0.08). Patients with inconsistent alarms occurred in 25.4% in the P1 and in 3.8% in the P2. Ignored consistent alarms were reduced from 21.5% to 2.6% (p = 0.004) in the P2 group. The educational program was a protective factor for the inconsistent clinical alarm (OR = 0.11 [95% CI 0.04–0.3]; p < 0.001) after adjustments for age, gender, and ASA physical status.

Conclusion

Customizing alarm settings on PACU admission proved to be a protective factor against inconsistent alarm notifications of multiparametric monitors.

Keywords

Anesthesia recovery period; Clinical alarms; Data management; Monitoring; Post-anesthetic care unit
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Braz J Anesthesiol

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