Authors

  1. Engel, Jill R. DNP, ACNP, FNP, ANP, NEA-BC, FAANP
  2. Lindsay, Mary DNP, RN, NEA-BC
  3. O'Brien, Stacey MSN, RN, NPD-BC
  4. Granger, Christopher B. MD
  5. Moore, Eric S. MD, MBA, MPH
  6. Hughes, Tracey MMCi
  7. Parker, Carley BA
  8. Miller, Corinne BSN, RN
  9. Fuchs, Mary Ann DNP, RN, NEA-BC, FAAN

Abstract

OBJECTIVE: The purpose of this quality improvement project was to improve health system patient safety by creating a cardiac monitoring structure aligned with national standards.

 

BACKGROUND: Excessive alarms pose patient safety threats and are often false or clinically insignificant. The Joint Commission identified reduction of nonactionable alarms as a National Patient Safety Goal.

 

METHODS: The conversion to structured monitoring occurred in 4 phases: 1) defining health system monitoring structure and processes; 2) co-create sessions; 3) implementation and impact analysis; and 4) ongoing evaluation and optimization.

 

RESULTS: Twenty-two clinical units participated. At the conclusion of phase 4, total 30-day alarm rates decreased by 74% at the academic hospital and by 92% and 95% at the community hospitals and were sustained for 12 months.

 

CONCLUSIONS: Decreasing alarm frequency can be safely achieved in academic and community hospitals by creating a system-wide monitoring infrastructure and standardized processes that engage interdisciplinary teams.