Telemetry Monitoring: Improvement Strategies for Everyone
Keywords:
telemetry, cardiac, monitoring, alarm fatigueAbstract
Anyone who has worked in the clinical setting with telemetry monitoring recognizes this constant sound representing a patient’s heartbeat. Just as a guard stands watch, it reassures us that a patient is safe and well. However, over time the sounds of telemetry can also become background noise. What happens when the noise stops? Do you notice?
Alarm fatigue occurs when individuals are desensitized to the overabundance of alarms, leading to a delayed response to actionable alarms. The Patient Safety Authority (PSA) heard the warning alarm and ran towards the challenge.
References
Kukielka E, Gipson KR, Jones R. A Brief Analysis of Telemetry–Related Events. Pat Saf. 2019;1(2):36–44. doi: 10.33940/biomed/2019.12.4
Medical Care Availability and Reduction of Error (MCARE) Act, Pub. L.No. 154 Stat. 13 (2002)
Najafi N. A Call for Evidence-Based Telemetry Monitoring: The Beep Goes On. JAMA Intern Med. 2014;174(11):1855–1856. Also available https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/1906997. Accessed August 15, 2018.
The Joint Commission. Hospital: 2015 National Patient Safety Goals. https://www.jointcommission.org/-/media/deprecated-unorganized/imported-assets/tjc/system-folders/assetmanager/2015_npsg_happdf.pdf?db=web&hash=653D52D69E2A1A351D7EDAA88273EF8C. Published 2020. Accessed January 13, 2020.
Patient Safety Authority. Hospital Telemetry Event Investigation Tool. Accessed January 25, 2021. Also available: http://patientsafety.pa.gov/pst/Documents/Telemetry/TelemetryEventInvestigation_2020_10.pdf Patient Safety Authority.
Patient Safety Authority. Telemetry Monitoring in PA- Introduction. 2020 [accessed 2021 Jan 25]. Also available: https://youtu.be/cKQ5s4S7p00
Patient Safety Authority. Telemetry Monitoring in PA—Alarm Fatigue: A Clinical Emergency Waiting to Happen. [Video]. YouTube. https://youtu.be/fg9MiNoBDIg. Published October 26, 2020. Accessed January 25, 2021.
Patient Safety Authority. Telemetry Monitoring in PA—Ensuring Continuous Monitoring Through a Hospital Visit. [Video]. YouTube. https://youtu.be/7BkJ-6LoGtg. Published October 26, 2020. Accessed January 25, 2021.
Patient Safety Authority. Telemetry Monitoring in PA—Eliminating Dead Batteries and End-of-Life Alarms. [Video]. YouTube. https://youtu.be/N4HYqVY6MF4. Published October 26, 2020. Accessed January 25, 2021.
Patient Safety Authority. Telemetry Monitoring in PA—Tips and Strategies to Combat Alarm Fatigue. Patient Safety Authority website. http://patientsafety.pa.gov/pst/Documents/Telemetry/Telemetry%20Monitoring%20Tips%20and%20Strategies.pdf. Published 2020. Accessed March 9, 2021.
Sandau KE, Funk M, Auerbach A, Barsness GW, Blum K, Cvach M, et al. Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association. Circulation. 2017;136(19):e273-e344. Epub 2017/10/05 doi: 10.1161/CIR.0000000000000527. PubMed PMID: 28974521.
Luo B, McLoone M, Rasooly IR, Craig S, Muthu N, Won J, Ruppel H, Bonafide CP. Analysis: Protocol for a New Method to Measure Physiologic Monitor Alarm Responsiveness. Biomed Instrum Technol. 2020 Nov 1;54(6):389-396. Accessed January 28, 2020. Also available: https://meridian.allenpress.com/bit/article/54/6/389/449918/ANALYSIS-Protocol-for-a-New-Method-to-Measure
Doyle E. Breaking the Telemetry Habit. Today’s Hospitalist. https://www.todayshospitalist.com/breaking-telemetry-habit/. Published 2020. Accessed December 11, 2020.
