Most of us are familiar with the children’s story, “The Boy Who Cried Wolf.” It’s about a bored young shepherd who (deliberately and falsely) cries out that a wolf is attacking the flock, so that the townspeople will rush to his aid. After a few false alarms, the townspeople started to ignore the shepherd’s pleas for help—including the one time they were genuine.
It’s human nature to respond to an emergency, and it’s also human nature to stop prioritizing “emergencies” that often turn out not to be real. But as with the story of the shepherd, that can result in disaster when it causes people not to respond urgently to an urgent need. That’s what happens in alarm fatigue.
Alarm fatigue is the sensory overload that happens when nurses and other healthcare professionals are exposed to an excessive number of alarms from patient care devices such as ventilators and vital signs monitors. Alarm fatigue is especially prevalent in the Intensive Care Unit (ICU), where medication pumps, feeding pumps, and other monitors and machines are constantly beeping away, demanding attention. In some units, there are hundreds of alarms per bed per day, and many thousands of daily alarms per unit.
Those sounds are intended to alert nurses and other care providers that a vulnerable patient needs attention. But research on alarm fatigue has indicated that 85%-99% of such signals are false or clinically insignificant. There are a number of reasons for these “false alarms:” overly sensitive devices, or machine settings that are not properly calibrated to a patient’s needs. In any case, roughly nine out of ten times that an alarm sounds, it turns out not to be an urgent or emergent situation. It’s understandable that with those odds, busy nurses might not respond as quickly as they would if most alarms were truly significant.
The problem is that sometimes,of course, there is an urgent patient need that demands an immediate response. Failure to respond in a timely fashion could result in serious harm to a patient, or even death. The reality is that alarm fatigue can lead clinicians to make medical mistakes, resulting in medical malpractice.
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is an independent, non-profit organization that strives to ensure good patient care through accrediting health care organizations. JCAHO has referred to alarm fatigue as one of the top ten technology hazards. The Emergency Care Research Institute (ECRI), another independent organization focused on healthcare safety, echoed this finding in 2020.
Recent numbers are harder to come by, but JCAHO counted 98 confirmed alarm-related events over the three years from 2009-2012. Eighty of these resulted in death, and the remainder resulted in permanent loss of function or other serious injury. However, note that these are confirmed numbers; the suspected number of likely alarm fatigue-related incidents during that period may be over 1,000. The U.S. Food and Drug Administration (FDA) similarly noted that over a seven-year period ending in 2012, there were 862 reported deaths.
It’s easy to imagine that those numbers would be even higher if measured today, especially in light of nursing staffing shortages since the onset of the COVID pandemic. But what can be done about alarm fatigue? It’s not physically possible, much less reasonable, to expect nursing staff to respond urgently to hundreds of alarms per day. What measures are being taken to protect patients? And what more can be done?
Alarm fatigue is dangerous to patients in a number of ways. Not only does it cause nurses to ignore alarms or respond more slowly, but it leads to nurse burnout. That in turn leads to staffing shortages, and a situation in which there may be even fewer nurses available to respond to too many alarms—and the cycle continues.
Because alarm fatigue has become such a problem in healthcare, researchers and medical professionals have tried to come up with solutions for this growing issue. Some proposed solutions have included:
By taking measures to prevent false alarms and help nurses prioritize the most urgent alarms, hospitals can improve patient safety.
If you or a loved one were in a hospital and suffered injury because a nurse failed to respond to an alarm in a timely fashion, you may have a legal claim against the nurse and the hospital. If so, you have only a limited amount of time in which to make your claim before it is barred forever.
It costs nothing to discuss your situation with an experienced medical malpractice attorney. An attorney can help you evaluate whether you have a claim and whether it is worthwhile to pursue an action for medical malpractice. To learn more about alarm fatigue and medical malpractice, contact the Fraser Law Firm to schedule a consultation.
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