Alarm Management
Alarm Management
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DOI：
10.1097/01.nur.0000311782.26413.8e
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发表时间：
2008-03
影响因子：
1.2
通讯作者：
Nancy Cook
中科院分区：
文献类型：
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作者：
Nancy Cook
目的：确定在嘈杂遥测单元工作的注册护士（RNs）是否能正确识别关键和非关键监测警报。意义：不正确的报警做法损害患者护理结果，违反既定的患者安全做法。员工对持续不断的警报噪音习以为常，可能会错过关键警报。背景/设计：许多护士将非关键警报标记为不重要，并且不回应这些警报。注册护士声称他们能够正确识别警报类型并准确使用监视器功能。方法：本研究采用单纯后测的非实验设计。注册护士雇员（N = 29）方便地从当地郊区医院的遥测部门取样。参与者完成了正规的心律失常教育计划，并在该单位工作了不少于1年。录音记录了机组上常见的10种危急和非危急报警声音。每个参与者被单独隔离在一个安静的房间里，给他们一张编号为1到10的纸。参与者听记录的警报，识别每个警报，并在答案键上标记其含义。研究发现：参与者正确识别了60%的警报。工作人员没有意识到“引线断开”、“所有引线断开”和“电池电量不足”有相同的警报级别和声音。这种特殊的警报声音通常被遥测单元忽略，因为RN认为警报反映了低电量警报。结论：工作人员不应该假设警报是非紧急的，然后选择不回应。在某些情况下，严重的心律失常，包括致命事件，可能会因为铅清除和RN未能评估和更换电极而错过。研究结果为注册护士自我评估遥测警报识别提供了客观的机会，并鼓励员工解决与单位监测实践相关的问题。临床专科护士应在年度工作人员能力中包括报警声音、识别和反应。当新设备被引入病房时，临床护理专家应评估报警声音，以确保它们可以很容易地区分。
Purpose: To determine if registered nurses (RNs) working on a noisy telemetry unit can correctly identify critical and noncritical monitor alarms. Significance: Incorrect alarm practices compromise patient care outcomes and violate established patient safety practices. Staff becomes acclimated to constant alarm noise and can miss critical alarms. Background/Design: Many nurses label noncritical alarms as unimportant and do not respond to these alerts. Registered nurses assert that they are able to correctly discern alarm types and accurately use monitor capabilities. Methods: This study used a posttest-only nonexperimental design. Registered nurse employees (N = 29) were conveniently sampled from a telemetry unit of a local suburban hospital. Participants had completed formal dysrhythmia education programs and had worked on the unit for no less than 1 year. Ten critical and noncritical alarm sounds commonly heard on the unit were audiotape recorded. Each participant was isolated individually in a quiet room and given a sheet of paper numbered 1 through 10. Participants listened to the recorded alarms, identified each alarm, and notated its meaning on the answer key. Findings: Participants correctly identified 60% of the alarms. Staff was unaware that ‘‘lead off,’’ ‘‘all leads off,’’ and ‘‘low battery’’ had the same alarm level and sound. This particular alarm sound was most commonly ignored on the telemetry unit because of RN belief that the alarm reflected a low-battery alert. Conclusions: Staff should not assume that an alarm is noncritical and subsequently choose to not respond. In some situations, significant dysrhythmias, including fatal events, could be missed because of lead removal and RN failure to assess and replace electrodes. Implications: Study findings provide an objective opportunity for RNs to self-evaluate telemetry alarm identification and encourage staff problem solving related to unit monitoring practices. The clinical nurse specialist should include alarm sounds, identification, and response in yearly staff competencies. As new equipment is introduced to the unit, the clinical nurse specialist should evaluate the alarm sounds to be sure that they can be easily differentiated.