Reducine the Risk of Alarm Fatigue Through the Use of Focused Management in Safety Huddles
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 812
- 试验地点
- 1
- 主要终点
- Change in alarm rate before and after intervention
研究概览
简要总结
Context: Alarm fatigue is a threat to hospital patient safety. National surveys reveal that high alarm rates interrupt patient care, reduce trust in alarms, and lead clinicians to disable alarms entirely. Safety huddles offer an appropriate forum for reviewing alarm data and identifying patients whose high alarm rates may necessitate safe tailoring of alarm limits.
Objectives: To evaluate the impact of a focused physiologic monitor alarm reduction intervention integrated into safety huddles that involves discussing safe monitor parameter adjustments on the physiologic monitor alarm rates of individual patients with high alarm rates who meet "low acuity" criteria.
Study Design: A prospective, quasi-experimental pilot study of the impact of the huddle intervention on the alarm rates of low acuity high alarm rate individual patients discussed in huddles in the PICU. The huddle intervention will consist of a script to facilitate the discussion of the alarm data.
Setting/Participants: Participants will include all low acuity patients and their providers in the PICU at The Children's Hospital of Philadelphia.
Study Interventions and Measures: The primary outcome is the rate of crisis and warning alarms per patient day for intervention cases as compared with others in the high alarm / low acuity cohort. Safety measures will include unexpected changes in patient acuity or code blue events within one week of monitor change or discharge.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Eligible primary participants will be the physicians and nurse practitioners caring for the PICU patients who are discussed as part of the huddle interventions. Eligible secondary participants will include all low acuity patients in the PICU at The Children's Hospital of Philadelphia.
- •Inclusion Criteria Primary Subjects: Any physician or nurse practioner caring for an intervention patient or control patient in the PICU at CHOP
- •Secondary Subjects:
- •Low acuity patients as determined by Optilink Guidelines
- •High alarm patients (top 10-20%)
- •Admission to the PICU
排除标准
- •Primary Subjects: None
- •Secondary Subjects: Patients who are medically ready for transfer out of ICU or discharge home (status continuously tracked by charge nurse). Patients who are medically ready for transfer out have an accepting service in place and a bed ready on the floor.
研究组 & 干预措施
Primary Subjects
Physicians and nurse practitioners caring for patients in the Pediatric Intensive Care Unit (PICU). An alarm reduction script will be used to help facilitate discussion of alarm data during weekday morning team "huddles".
干预措施: Alarm Reduction Script (Other)
结局指标
主要结局
Change in alarm rate before and after intervention
时间窗: 24 hours before intervention and 72 hours after intervention
Within-subject comparison evaluating the numbers of alarms and the trajectories of alarm rates in the 24 hours before and up to 72 hours after each huddle
次要结局
未报告次要终点