Communication strategies and timeliness of response to life critical telemetry alarms.

Department of Cardiovascular Medicine, Beaumont Hospital, OUWB School of Medicine, Royal Oak, Michigan 48073, USA.
Telemedicine and e-Health (Impact Factor: 1.54). 04/2011; 17(4):241-6. DOI: 10.1089/tmj.2010.0139
Source: PubMed

ABSTRACT A centralized electrocardiogram telemetry monitoring system (TMS) facilitates early identification of critical arrhythmias and acute medical decompensation. Timely intervention can only be performed if abnormalities are communicated rapidly to the direct caregiver. The study objectives were to measure effectiveness of bi-directional voice communication badges versus one-way alphanumeric pagers for telemetry alarm response and communication loop closure.
A sequential observational pilot study of nursing response to TMS alarms compared communication technologies on four nursing units in a 1,061 bed tertiary care hospital with 264 TMS channels of telemetry over a 2-year period. Subsequently, the communication technologies were compared in a randomized fashion on a 68-bed progressive cardiac care unit. Caregivers were blinded to the protocol. All alarm responses were recorded during two periods using either pagers or voice communication devices. Alarm response time and closure of the communication loop were analyzed in a blinded fashion.
The direct communication functionality of the badge significantly shortened the time to first contact, time to completion, and rate of closure of the communication loop in both the pilot and study phases. Median time to first contact with the communication badge was 0.5  min, compared to 1.6  min with pager communication (p < 0.0003). Communication loop closure was achieved in 100% of clinical alarms using the badge versus 19% with the pager (p < 0.0001).
Communication badge technology reduced alarm time to first contact and completion as well as facilitated communication loop closures. Immediate two-way communication significantly impacted practice, alarm management, and resulted in faster bedside care.

  • [Show abstract] [Hide abstract]
    ABSTRACT: This study examined organizational and individual variables impacting patient risk detection by Intensive Care Unit nurses and their decision to reduce the risk of failure to rescue. Thirty-four nurses were randomly assigned to two groups. A video of a manager and staff nurse patient safety discussion was used to prime one group to prioritize patient safety. Participants provided demographic information, received end-of-shift report on two fictional patients, experienced 52 alarm trials during a medication preparation scenario, and completed the Safety Attitude Questionnaire. No difference existed in risk detection; however, nurses who perceived their work environment quality to be good correctly ignored a clinically irrelevant alarm more often and were more apt to classify an alarm as irrelevant. They chose to reduce the risk of medication error rather than that of failure to rescue. This information can assist nurses to balance disregarding distractions with responding to potential patient risk signals.
    Clinical Nursing Research 06/2013; 23(5). DOI:10.1177/1054773813490951 · 0.87 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Alarm fatigue desensitizes nurses to alarm signals and presents potential for patient harm. This project describes an innovative method of communicating cardiac monitor alarms to pagers using an alarm escalation algorithm. This innovation was tested on 2 surgical progressive care units over a 6-month period. There was a significant decrease in mean frequency and duration of high-priority monitor alarms and improvement in nurses' perception of alarm response time, using this method of alarm communication.
    Journal of nursing care quality 08/2013; 29(1). DOI:10.1097/NCQ.0b013e3182a61887 · 1.09 Impact Factor

Full-text (3 Sources)

Available from
May 20, 2014