Alarm Fatigue

Alarm fatigue is a psychological phenomenon that occurs when a person is repeatedly exposed to alarm or alert noises and subsequently becomes desensitized to them. After desensitization, a person may fail to notice the sound of an alarm or may have reduced response time when hearing alarms. Alarm fatigue is a concern in industries where alarms are used to protect health and safety and has been linked to accidents in the health care, construction and heavy equipment, and mining industries.

Brief History

The first documented study of alarm fatigue involved a 1974 report by the Emergency Care Research Institute (ECRI) regarding the use of machines used to warm the bodies of patients suffering from hypothermia. The machines used various types of blinking lights to signify normal function and burning risk. Because the lights blinked continually, nurses became desensitized to the signal and failed to notice risk indicators. A study published in 2023 in Preoperative Care & Operating Room Management reported that hospital workers hear an average of 1,000 alarms per shift. Accidental triggering is common, and according to Nurse.org in 2022, between 72 and 99 percent of all hospital alarms were false.

The death of a heart patient in 2010 at Massachusetts General Hospital in Boston helped to inspire national interest in the alarm-fatigue issue. The Joint Commission, a US organization that accredits health care centers, released a study three years later indicating that eighty fatalities and thirteen severe injury cases between 2009 and 2012 were related to alarm fatigue. The organization began taking steps to remedy the problem. By 2021, the Joint Commission announced a plan to reduce alarm-fatigue-related fatalities by improving alarm management. It sought to minimize false and nuisance alarms. The report indicated plans to safeguard patient safety, reduce staff burnout, and improve the sensitivity of oxygen saturation monitoring to quickly detect emergencies.

Overview

Alarm fatigue is a major concern in health care, where patient status is often communicated to nursing staff via numerous alarm signals. False alarms cause patient injuries and fatalities, as well as staff burnout. Alarm fatigue is not unique to health care, however. It has also been linked to accidents in the construction and mining industries, especially in regard to the use of heavy machinery. Alarms are frequent in both industries and used to warn workers when heavy machinery is close by and poses a risk. One of the earliest studies on the issue was a 1986 report in the Proceedings of the Human Factors and Ergonomics Society, which indicated that noise pollution and the failure to distinguish between relevant and irrelevant alarms was a major safety hazard in mining and construction. According to a 2020 article in Sensors, alarm fatigue in the construction industry was often caused by proximity warning systems. These alarms were so frequent that workers disabled the systems or ignored the alarms, significantly increasing the chance of injury. Alarm fatigue has also been identified as a problem in the transportation industry, where train dispatchers hear thousands of alarms per week.

Across all industries, the primary recommended strategy for combating alarm fatigue has been to reduce the number of alarms. Further, research suggests that varying levels of alarm signals is effective, making emergency alarms louder while caution alarms are reduced in intensity. Other suggestions include using computer-aided systems to personalize alarm signals to relevant personnel, thereby reducing the frequency of exposing workers to irrelevant alarms. The Boston Medical Center, a pioneer in the study of alarm fatigue, reduced the number of alarms healthcare workers were exposed to per week from 87,829 to 9,967. Many nurses indicated that the reduction in alarms enabled them to spend more time caring for patients instead of responding to alarms. Patient and physician satisfaction also arose. A proposed solution for the construction industry was to use "personal sensors" linked to specific workers. These sensors would activate only when the worker in question was at risk from approaching vehicles or other types of work-related hazards. The use of computer monitors and personal sensors could help to reduce the number and frequency of alarms, thereby making remaining alarm signals more relevant and noticeable.

Bibliography

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