Alarm Fatigue
Alarm fatigue is a psychological response that occurs when individuals are repeatedly exposed to alarm sounds, leading to desensitization and a diminished response to these alerts. This phenomenon is particularly concerning in various industries, including healthcare, construction, and mining, where alarms are essential for health and safety. In healthcare settings, for instance, nurses may encounter an overwhelming number of alarms, with studies indicating that hospital workers hear an average of 1,000 alarms per shift, many of which are false. Such unnecessary alerts can lead to patient injuries and even fatalities, underscoring the seriousness of alarm fatigue.
The issue isn't confined to healthcare; it extends to the construction industry, where proximity alarms are frequently ignored due to their high volume, increasing the risk of accidents. Research has highlighted the importance of distinguishing between relevant and irrelevant alarms to enhance safety across sectors. Strategies to combat alarm fatigue typically focus on reducing alarm frequency and varying the intensity of alerts, ensuring that critical alarms are more noticeable. Innovative solutions, such as personalized alarm systems and targeted sensors, aim to improve safety and efficiency for workers in high-risk environments. Overall, addressing alarm fatigue is vital for protecting individuals and enhancing operational effectiveness in alarm-reliant industries.
Alarm Fatigue
Alarm fatigue is a psychological phenomenon that occurs when a person is repeatedly exposed to alarm or alert noises and subsequently becomes desensitized to them. After desensitization, a person may fail to notice the sound of an alarm or may have reduced response time when hearing alarms. Alarm fatigue is a concern in industries where alarms are used to protect health and safety and has been linked to accidents in the healthcare, construction and heavy equipment, and mining industries.
Brief History
The first documented study of alarm fatigue involved a 1974 report by the Emergency Care Research Institute (ECRI) regarding the use of machines used to warm the bodies of patients suffering from hypothermia. The machines used various types of blinking lights to signify normal function and burning risk. Because the lights blinked continually, nurses became desensitized to the signal and failed to notice risk indicators. A study published in 2023 in Preoperative Care & Operating Room Management reported that hospital workers hear an average of one thousand alarms per shift. Accidental triggering is common, and according to Nurse.org in 2022, between 72 and 99 percent of all hospital alarms were false.
The death of a heart patient in 2010 at Massachusetts General Hospital in Boston helped to inspire national interest in the alarm-fatigue issue. The Joint Commission, a US organization that accredits healthcare centers, released a study three years later indicating that eighty fatalities and thirteen severe injury cases between 2009 and 2012 were related to alarm fatigue. The organization began taking steps to remedy the problem. By 2021, the Joint Commission announced a plan to reduce alarm-fatigue-related fatalities by improving alarm management. It sought to minimize false and nuisance alarms. The report indicated plans to safeguard patient safety, reduce staff burnout, and improve the sensitivity of oxygen saturation monitoring to quickly detect emergencies.
Overview
Alarm fatigue is a major concern in health care, where patient status is often communicated to nursing staff via numerous alarm signals. False alarms cause patient injuries and fatalities, as well as staff burnout. Alarm fatigue is not unique to health care, however. It has also been linked to accidents in the construction and mining industries, especially in regard to the use of heavy machinery. Alarms are frequent in both industries and used to warn workers when heavy machinery is close by and poses a risk. One of the earliest studies on the issue was a 1986 report in the Proceedings of the Human Factors and Ergonomics Society, which indicated that noise pollution and the failure to distinguish between relevant and irrelevant alarms was a major safety hazard in mining and construction. According to a 2020 article in Sensors, alarm fatigue in the construction industry was often caused by proximity warning systems. These alarms were so frequent that workers disabled the systems or ignored the alarms, significantly increasing the chance of injury. Alarm fatigue has also been identified as a problem in the transportation industry, where train dispatchers hear thousands of alarms per week.
Across all industries, the primary recommended strategy for combating alarm fatigue has been to reduce the number of alarms. Further, research suggests that varying levels of alarm signals is effective, making emergency alarms louder while caution alarms are reduced in intensity. Other suggestions include using computer-aided systems to personalize alarm signals to relevant personnel, thereby reducing the frequency of exposing workers to irrelevant alarms. The Boston Medical Center, a pioneer in the study of alarm fatigue, reduced the number of alarms healthcare workers were exposed to per week from 87,829 to 9,967. Many nurses indicated that the reduction in alarms enabled them to spend more time caring for patients instead of responding to alarms. Patient and physician satisfaction also arose. A proposed solution for the construction industry was to use "personal sensors" linked to specific workers. These sensors would activate only when the worker in question was at risk from approaching vehicles or other types of work-related hazards. The use of computer monitors and personal sensors could help to reduce the number and frequency of alarms, thereby making remaining alarm signals more relevant and noticeable.
Bibliography
Albanowski, Kimberly. "Ten Years Later, Alarm Fatigue Is Still a Safety Concern." AACN Advanced Critical Care, vol. 34, no. 3, Fall 2023, pp. 189-197, doi.org/10.4037/aacnacc2023662. Accessed 25 Oct. 2024.
Anderson, Cameron J. et al., "Improving Auditory Alarms: Reducing Perceived Annoyance with Musical Timbre (A Randomized Trial)." Preoperative Care and Operating Room Management, vol. 32, Sept. 2023, doi.org/10.1016/j.pcorm.2023.100332. Accessed 26 Oct. 2024.
Blackmon, R., and A. Gramopadhye. "Improving Construction Safety by Providing Positive Feedback on Backup Alarms." Journal of Construction Engineering and Management 121.2 (1995): 166–71. Print.
Colliver, Victoria. "Hospitals Look to Reduce Danger of ‘Alarm Fatigue.’" San Francisco Chronicle. Hearst Corp., 23 Oct. 2013. Web. 6 Dec. 2014.
Cvach, Maria. "Monitor Alarm Fatigue: An Integrative Review." Biomedical Instrumentation and Technology 46.4 (2012): 268–77. Print.
Drew, Barbar J., et al. "Insights into the Problem of Alarm Fatigue with Physiological Comprehensive Observational Study of Consecutive Intensive Care Patients." PLoSONE 22 Oct. 2014: n. pag. Web. 6 Dec. 2014.
Gaines, Kathleen. "Alarm Fatigue Is Way Too Real (and Scary) for Nurses." Nurse.org, 15 Nov. 2022, nurse.org/articles/alarm-fatigue-statistics-patient-safety/. Accessed 25 Oct. 2024.
Knox, Richard. "Silencing Many Hospital Alarms Leads to Better Health Care." NPR.Natl. Public Radio, 27 Jan. 2014. Web. 6 Dec. 2014.
Leary, Jenny Eriksen. "BMC Alleviates Alarm Fatigue by Decreasing Noise." BMC: In the News. Boston Medical Center, 14 Jan. 2014. Web. 6 Dec. 2014.
Sendelbach, Sue, Marjorie Funk, and Mary Fran Tracy. "Alarm Fatigue: A Patient Safety Concern." AACN Advanced Critical Care 24.4 (2013): 378–86. Print.
"Too Much Noise from Hospital Alarms Poses Risk for Patients." Washington Post. Washington Post, 2013. Web. 6 Dec. 2014.
Wald, Matthew L. "For No Signs of Trouble, Kill the Alarm." New York Times. New York Times, 31 July 2010. Web. 6 Dec. 2014.