Background: Alarm fatigue is a serious patient safety issue and represents a 2015 National Patient Safety Goal.  False alarms can mask true alarms, and may contribute to suboptimal patient care practices.  Cardiac telemetry monitoring in particular has been a focus in the Choosing Wisely campaign and at our institution. Purpose: A comprehensive, multidisciplinary approach was [...]

Background: Clinicians rely on physiologic monitor alarms to notify them of their patients’ changing vital signs. Currently, alarms occur very frequently and usually do not warrant clinical intervention. High alarm burden can lead to alarm fatigue, often observed as a slower response or unintentional ignoring of clinically important alarms. For this reason, alarm fatigue has [...]

Background: Critical lab values are those results that require rapid notification to clinical staff so that urgent interventions can be made to avoid morbidity or mortality. The Joint Commission requires that hospitals have an effective critical lab value process in place.  The process is a time-consuming multi-step progression of phone calls with associated documentation.  The [...]

Background: Previous studies examining continuous patient monitoring in the ICU and emergency department suggest that substantial telemetry alarm burden combined with a high proportion of false positive alerts may jeopardize patient outcomes. Currently, little is known about the burden and value of specific alarms on the general wards. Methods: As part of a quality improvement [...]

Background: Overuse of non-ICU continuous cardiac (telemetry) monitoring is a well-documented problem that leads to increased hospital cost, alarm fatigue, nursing time loss, and patient discomfort. It is often ordered for detection of clinical deterioration or higher level of nursing care, without corroborating evidence. Several studies have looked at different interventions to reduce inappropriate telemetry [...]

Background: In 2004, the American Heart Association (AHA) published recommendations on the use of cardiac monitoring in the hospital setting. It provided a rating system for its indications (Class I-III), which stratify the likelihood of benefit. In June 2013, The Joint Commission approved NPSG.06.01.01, a patient safety goal on clinical alarm use in the hospital [...]

Background: Telemetry overuse contributes to excess healthcare costs, unnecessary workup of incidentalomas, and alarm fatigue. To curb overuse, guidelines such as the 2017 AHA/ACC continuous ECG monitoring practice standards have outlined appropriate telemetry use standards. The aim of this study was to perform a rapid “plan-do-study-act” (PDSA) cycle and assess whether a nursing (RN)-driven checklist [...]