Prevalence, Proportionality, and Cause of Ventilator Alarms in a Pediatric Intensive Care Setting.

alarm fatigue alarm priority cause critical alarm frequency pediatric intensive care unit prevalence proportionality rate ventilator alarms

Journal

Respiratory care
ISSN: 1943-3654
Titre abrégé: Respir Care
Pays: United States
ID NLM: 7510357

Informations de publication

Date de publication:
Apr 2021
Historique:
pubmed: 10 12 2020
medline: 27 4 2021
entrez: 9 12 2020
Statut: ppublish

Résumé

Clinical alarms play an important role in monitoring physiological parameters, vital signs and medical device function in the hospital intensive care environment. Delays in staff response to alarms are well documented as health care providers become desensitized to increased rates of nuisance alarms. Patients can be at increased risk of harm due to alarm fatigue. Current literature suggests alarms from ventilators contribute significantly to nonactionable alarms. A greater understanding of which specific ventilator alarms are most common and the rates at which they occur is fundamental to improving alarm management. A retrospective review was performed on alarms that occurred on the Avea and Servo-i ventilators used in the pediatric ICU and pediatric cardiothoracic ICU at a major metropolitan children's hospital. High- and medium-priority alarms, as classified by the manufacturer, were studied between June 1, 2017, and November 31, 2017. Descriptive data analysis and a 2-proportion z-test were performed to identify proportionality, cause, and prevalence rates in the pediatric ICU and the cardiothoracic ICU. Eleven distinct ventilator alarms were identified during 2,091 d of mechanical ventilation. The Inspiratory Flow Overrange alarm (42.4%) on the Servo-i, Low V The cause and proportion of alarms varied by ventilator and care unit. High-priority alarms were most common with the Avea and medium-priority alarms for the Servo-i. The overall combined ventilator alarm prevalence rate was 22.5 alarms per ventilator-day per patient.

Sections du résumé

BACKGROUND BACKGROUND
Clinical alarms play an important role in monitoring physiological parameters, vital signs and medical device function in the hospital intensive care environment. Delays in staff response to alarms are well documented as health care providers become desensitized to increased rates of nuisance alarms. Patients can be at increased risk of harm due to alarm fatigue. Current literature suggests alarms from ventilators contribute significantly to nonactionable alarms. A greater understanding of which specific ventilator alarms are most common and the rates at which they occur is fundamental to improving alarm management.
METHODS METHODS
A retrospective review was performed on alarms that occurred on the Avea and Servo-i ventilators used in the pediatric ICU and pediatric cardiothoracic ICU at a major metropolitan children's hospital. High- and medium-priority alarms, as classified by the manufacturer, were studied between June 1, 2017, and November 31, 2017. Descriptive data analysis and a 2-proportion z-test were performed to identify proportionality, cause, and prevalence rates in the pediatric ICU and the cardiothoracic ICU.
RESULTS RESULTS
Eleven distinct ventilator alarms were identified during 2,091 d of mechanical ventilation. The Inspiratory Flow Overrange alarm (42.4%) on the Servo-i, Low V
CONCLUSIONS CONCLUSIONS
The cause and proportion of alarms varied by ventilator and care unit. High-priority alarms were most common with the Avea and medium-priority alarms for the Servo-i. The overall combined ventilator alarm prevalence rate was 22.5 alarms per ventilator-day per patient.

Identifiants

pubmed: 33293363
pii: respcare.07200
doi: 10.4187/respcare.07200
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

541-550

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2021 by Daedalus Enterprises.

Auteurs

Leo Langga (L)

Department of Respiratory Care, Children's Hospital Los Angeles, Los Angeles, California. leolangga@gmail.com.
School of Public Health, Health Policy and Leadership, Loma Linda University, Loma Linda, California.

Jisoo Oh (J)

School of Public Health, Health Policy and Leadership, Loma Linda University, Loma Linda, California.

David López (D)

Department of Cardiopulmonary Sciences, School of Allied Health Profession, Loma Linda University, Loma Linda, California.

Nancy Blake (N)

Harbor UCLA Medical Center, Torrance, California.

Edward McField (E)

Center for Community Health Policy, Loma Linda, California.

Justin Hotz (J)

Department of Respiratory Care, Children's Hospital Los Angeles, Los Angeles, California.
Anesthesia Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, California.

Leonardo Nava-Guerra (L)

Anesthesia Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, California.
Medtronic, Los Angeles, California.

Kelby Knox (K)

Anesthesia Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, California.
University of Southern California, Los Angeles, California.

Richard Chinnock (R)

School of Public Health, Health Policy and Leadership, Loma Linda University, Loma Linda, California.
Loma Linda University Children's Hospital, Loma Linda, California.

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