Clinical Alarm Safety

Submitter Information

Author: Tammy Spencer, MS, RN
Title: Senior Instructor
Institution: University of Colorado Denver College of Nursing
Email: tammy.spencer@uchsc.edu
Coauthors: Kathy Foss, MS, RN

Competency Category(s)
Safety

Learner Level(s)
Pre-Licensure ADN/Diploma, Pre-Licensure BSN

Learner Setting(s)
Clinical Setting

Strategy Type
Case Studies

Learning Objectives

  • Delineate general categories of errors and hazards in care.
  • Communicate observations or concerns related to hazards and errors to patients, families and the health care team.
  • Value own role in preventing errors.
  • Describe factors that create a culture of safety.
  • Value vigilance and monitoring (even of own performance of care activities) by patients, families, and other members of the health care team.

Strategy Overview

Reading for this activity: As a preparation for this learning activity, clinical instructors should read the following article on alarm safety. Some instructors may want to assign this article to students before assigning this learning activity:
Phillips, J. (2006) Clinical alarms: complexity and common sense. Critical Care Nursing Clinics of North America. 18: 145-156.
Instructor Instructions: This activity involves student data collection of the alarms they hear and see in the clinical setting. It is anticipated that the student collects data on a single pre-determined clinical shift. Data is gathered and shared with the other students in a single post clinical conference. This exercise may be utilized with students as they begin to experience more independent care of their patient in which they are responsible for not only the basic components of patient care, but the recognition, interpretation and response to clinical alarms. Students are also made aware of the culture of alarm response in their unit, as well as how nurses are educated in alarm safety. The accompanying Learning Activity takes the student through an exercise in which data is gathered on the included table regarding the type, source and interpretation of an alarm as well as the action taken when the alarm is activated. The student is challenged to understand the complexity of alarm response as well as the safety implications for patient care. It is the intent of the Learning Activity to provoke discussion around the role and responsibility of the nurse in alarm safety. An evaluation follows this exercise. Students need to complete the evaluation and return it to the clinical instructor. At the end of the rotation, please return the evaluations to the course coordinator.
Instructions for the Learning Activity: Alarm Safety
Using the attached worksheet, students are to record the auditory and visual alarms encountered in the clinical setting during one clinical shift.
The worksheet includes data regarding the type of the alarm, the location of the alarm, the student’s interpretation of the alarm as well as the action taken.
Students should include not only alarms that are pertinent to their patient, but any other alarms they encounter or notice related to the patients on their unit.
Discussion Questions:
Following completion of the Learning Activity, use the following questions as a guide for clinical instructor/student discussion:
1. What are the various influences on clinician responses to alarms? For example: Physical barriers, physical layout of the unit, RN-pt ratio.
2. How, as a student, are you educated about alarms and your response to them? How might education regarding the various patient alarms be an issue associated with alarm response?
3. Who is responsible for alarm response?
4. Based on your observations, why are alarms ignored?
5. Who is responsible for testing and managing alarms on your unit? How are limits set on alarms?
6. What is a nuisance alarm? How did the alarm become a nuisance alarm? What is the danger in classifying an alarm as a nuisance alarm?
7. If asked by a patient about a specific alarm, how would you respond? How does your response play a role in your patient’s perception of their care?
8. What is meant by alarm prioritization? How are alarms prioritized on your unit?

Submitted Materials

97.QSEN_alarm_safety_worksheet.doc

Additional Materials

Evaluation Description

Student Evaluation: Alarm Safety
What did you learn about the impact of alarm safety on patient safety?
How is alarm response a nursing/health issue?
Who is responsible for responding to alarms?
Did you find this learning activity to be useful?
Comments:
Please return this form to your clinical instructor.