Survey And Analysis Of ICU Bedside Monitor Alarm

Objectives:Monitor is indispensable equipment for every intensive care unit(ICU) patient. It monitor and analyze heart rate, heart rhythm, respiratory rate, blood pressure and oxygen saturation of patients. Therefore patients’safety is directly affected by the accuracy of monitor’measurement and alarm,medical staff timely responsiveness and disposal to alarm. In this study, we use the obtained data to analyze the alarms and realize the current condition of monitor alarm. It provide basic data for establishing more perfect alarm management and process flow.Methods:This study use self-design sheets to collect consecutive seven day alarm records and handling results in an ICU of a Grade A Class Three hospital in Hangzhou. Besides it also collect basic information of patients and bedside nurses, who participate in the survey. It use software SPSS16.0and two nonparametric statistical methods(Mann-Whitney、Kruskal-Wallis) to analysis datas. Significant level set at0.05.Results:From the statistical analysis results of monitor alarms, we can observe that the average monitor alarms per ICU patient each day is37times. The correct alarms only account for34.6%, while the false-alarms account for65.4%. The false-alarm rate of arrhythmia alarms reaches up to99.9%, the false-alarm rate of respiratory rate account for86.7%, the false oxygen saturation alarm occupies63%of all oxygen saturation alarms, respectively. The effective alarm rates in this ICU just take up to3.5%of all. The alarm rate which need to call a doctor is only1.4%of all. The mean time of bedside nurses’reaction to alarms is40seconds. Meantime, the patient’s APACHE Ⅱ score with in24hours of admission, alarm types, time segment of alarm, nurse’s gender, age, professional qualifications and working years in ICU significantly affect the responsiveness of nurses for handling the monitor alarms.Conclusions:The false alarm and meaningless alarm rate is high. The false-alarm rate of arrhythmia is the highest. Further CQI project should be done to solve the problem. The time of bedside nurses’reaction to alarms is slow. Alarm fatigue exists in ICU. Reaction time to alarm should be definitely ruled in alarm regime. Nurses who are older,worked longer in ICU need continuous in-service education about the function of monitor and alarm regime.