. Tanushree Sahoo; . Meena Joshi; . Shamnad Madathil; . Ankit Verma; . Mari Jeeva Sankar; . Anu Thukral
Volume 9, Issue 10 , October 2019, , Pages 1-7
Abstract
INTRODUCTION: Unnecessary and excessive activation of alarms (“false alarm”) in neonatalintensive care unit (NICU) often results in alarm fatigue among health‑care professionals, ...
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INTRODUCTION: Unnecessary and excessive activation of alarms (“false alarm”) in neonatalintensive care unit (NICU) often results in alarm fatigue among health‑care professionals, which canpotentially result in deleterious effects in sick neonates.AIMS AND OBJECTIVES: The aim of this study is to reduce the frequency of false alarms frommultiparameter monitors (MPM) by 50% from the existing baseline level over a period of 12 weeks.METHODS: In this quality improvement (QI) project conducted over 1 year (November2016–October 2017) at All India Institute of Medical Sciences, New Delhi, we collected data onactivation of false alarms from MPM (outcome measure) over a period of 2 months in 134 randomlyselected observations of 1‑h duration (baseline phase [10 days, 20 observations] and developingand testing the changes in five Plan‑Do‑study‑Act (PDSA) cycles over the next 50 days, 114observations. We also measured the pre‑ and postassessment of knowledge level in use of MPMamong health‑care professionals using checklist (process measure). Following that, we continueddata collection for next 10 months to check sustenance of the project.RESULTS: Baseline characteristics including gestation, birth weight, and sickness level did not varyduring the study period. The median (range) number of activation of false alarms/hour/MPM was23 (18–35) in the baseline phase. This reduced to 22 (17–30), 19 (15–30), 16 (14–30), 14 (8–17),and 9 (6–12) at the end of 1st, 2nd, 3rd, 4th, and 5th PDSA cycles, respectively. In sustenance phase,it could be maintained in target range from January 2017 to October 2017.CONCLUSIONS: Small sustained changes can contribute a lot in continuous QI in decreasing falsealarms and subsequent improvement of neurodevelopmental outcomes discharged neonates.