Alarm fatigue can cause mistakes and harm patients

The hospital is never a quiet place.

Walk through the wards on a typical day, and you’ll hear a cacophony of alarms, bells, and other tones coming from both computers and medical equipment.

American Medical News recently discussed so-called “alarm fatigue.”  They cite a study showing find that “16,934 alarms sounded in [a medical] unit during an 18-day period.”

That’s astounding, and for those who are wondering, that’s about 40 alarms an hour.

It’s not surprising that doctors become desensitized to these alarms, and that has potential to harm patients, as physicians may miss legitimate, emergent findings.

Alarm fatigue is also prevalent in electronic medical records.  For instance, take drug interactions.  Many EMRs aren’t sophisticated enough to differentiate between drug interactions that are minor in nature, versus those that are absolute contraindications.  The result is a plethora of alarms — not dissimilar to the Window Vista’s flawed User Account Control option — which numbs the user due to sheer amount of alerts.

The answer, of course, is to tier alerts.  Absolute emergencies should be different from those that are less important.  Adding that simple layer of nuance can highlight more critical alerts, thus ensuring more doctors will pay attention to them.

Sadly, it’s not a straightforward solution:

Solving the problem requires long-term dedication. Hospitals and their care units must evaluate their needs and develop alarm management plans. Responsibilities should be delegated and staff should be able to tailor alarm defaults for particular units or patients, such as adjusting a monitor alarm for a long-distance runner with a lower heart rate than average.

But it’s a problem that’s worth tackling, as more clinics and hospitals become reliant on digital equipment.

 is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on FacebookTwitterGoogle+, and LinkedIn.

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