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Tips to help staff respond to clinical alarms

Ambulatory Safety Monitor, January 21, 2004

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The JCAHO's National Patient Safety Goal #6 requires that your clinical alarm systems work properly and are "sufficiently audible" amid noise on the unit.

To get a sense of how well your organization complies with the requirement, you need to verify that staff can hear critical, clinical alarms-ones that directly impact patient safety, such as cardiac monitors. Next, you must determine how well and quickly staff respond to the alarms.

To address compliance, the environment of care committee at Valley Regional Medical Center in Claremont, NH, developed and launched a new patient safety policy for assessing the effectiveness of all of the facility's critical clinical alarms. The policy requires staff to take the following steps:

1. List all of the organization's equipment that have alarms.

2. Establish a baseline response of how quickly the organization wants staff to respond to each alarm, and what, at a minimum, the staff member should do. The environment of care staff developed these baseline expectations by meeting with various nurses and nurse managers. This helped the team distinguish between a "positive response" and a "failed response" during their drills.

3. Assess how quickly and appropriately staff respond to each critical alarm. Several critical alarms for drills could include cardiac monitors, medical gas alarms, and the nurse call system.

4. Rate staff on their alarm response. A positive response during a drill is one in which the nurse arrives at the patient's bedside within a predetermined amount of time, knows why the alarm is sounding, and takes the proper steps to address the situation that caused the alarm. A failed response is one in which the nurse fails to arrive at the patient's bedside within a certain time period, does not know why the alarm is sounding, or doesn't take appropriate steps to address the situation that set off the alarm.

Nurses could also fail if they arrive on time and know why the alarm sounds, but do not respond correctly. Even if one nurse fails at Valley Regional Medical Center, all unit staff must undergo critical alarm inservice training, says Mark Woods, a private contractor who serves as the hospital's biomedical equipment technician.

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