Profiling False ECG Crisis Alarms and Potential Causes

Abstract

Background: The Joint Commission determines that clinical alarm systems are one of the highest patient safety issues. The Emergency Care Research Institute (ECRI) lists alarm overload as the 6th of the top 10 health technology hazards seen in healthcare technology-related issues. Despite the American Heart Association (AHA) recommendations for continuous Electrocardiographic (ECG) monitoring of hospitalized patients for heart rate and rhythm determination to diagnose arrhythmias, false arrhythmia alarms remain an issue for monitoring patients in the intensive care unit. Purpose: The purpose of this Doctoral of Nursing Practice (DNP) project was to determine the frequency, accuracy, and potential causes of false ECG crisis alarms. Methods: A retrospective quantitative descriptive study was conducted from an alarm database on a 12-bed adult intensive care unit within a hospital in the Southwest region of the United States. Results: The majority (95%) of crisis alarms in the intensive care units are false. The study showed high inter-rater reliability in false alarm determination. Out of 471 ECGs reviewed, 22 ECG alarms were true, two ECG alarms were undetermined, and 446 ECG alarms were false. The main non mutually exclusive causes of false alarms were artifacts (n=418, 93.7%), followed by low ECG amplitude (n = 264, 59.2%). Conclusion: The result of the project showed a high rate of false crisis alarms in the intensive care units. The findings of this project identified a need to develop quality alarm initiatives to decrease false ECG alarms and clinical alarm fatigue. This DNP project focused on evidence-based practice initiatives to address false crisis alarms.