Purpose:
To determine if registered nurses (RNs) working on a noisy telemetry unit can correctly identify critical and noncritical monitor alarms.
Significance:
Incorrect alarm practices compromise patient care outcomes and violate established patient safety practices. Staff becomes acclimated to constant alarm noise and can miss critical alarms.
Background/Design:
Many nurses label noncritical alarms as unimportant and do not respond to these alerts. Registered nurses assert that they are able to correctly discern alarm types and accurately use monitor capabilities.
Methods:
This study used a posttest-only nonexperimental design. Registered nurse employees (N = 29) were conveniently sampled from a telemetry unit of a local suburban hospital. Participants had completed formal dysrhythmia education programs and had worked on the unit for no less than 1 year. Ten critical and noncritical alarm sounds commonly heard on the unit were audiotape recorded. Each participant was isolated individually in a quiet room and given a sheet of paper numbered 1 through 10. Participants listened to the recorded alarms, identified each alarm, and notated its meaning on the answer key.
Findings:
Participants correctly identified 60% of the alarms. Staff was unaware that "lead off," "all leads off," and "low battery" had the same alarm level and sound. This particular alarm sound was most commonly ignored on the telemetry unit because of RN belief that the alarm reflected a low-battery alert.
Conclusions:
Staff should not assume that an alarm is noncritical and subsequently choose to not respond. In some situations, significant dysrhythmias, including fatal events, could be missed because of lead removal and RN failure to assess and replace electrodes.
Implications:
Study findings provide an objective opportunity for RNs to self-evaluate telemetry alarm identification and encourage staff problem solving related to unit monitoring practices. The clinical nurse specialist should include alarm sounds, identification, and response in yearly staff competencies. As new equipment is introduced to the unit, the clinical nurse specialist should evaluate the alarm sounds to be sure that they can be easily differentiated.
Section Description
The following clinical nurse specialist student abstracts were selected for poster presentations.