ALARM FATIGUE in Nursing UniversityInformatics.docx

ALARM FATIGUE in Nursing
University
Informatics
Why is this important to me?
I am completely numb to most alarms after working in acute
care medical surgical. It is scary! I would like to understand
more about what can be done since technology will only
increase.
What is Alarm Fatigue?
Defined as a Desensitized response to medical alert equipment
and technologies due to the frequency
Sensory Overload
Too many phones, pagers and overhead announcements
Missed critical events
Patient safety concerns
Over stimulated staff

Outline
Define Alarm Fatigue
How Alarm Fatigue effects Healthcare
Share the Evidenced Based Data
Explore the Adverse Events
Discover a solution
What are the challenges and benefits
Can a solution be implemented?
Potential References
Citing reports of alarm-related deaths, the Joint Commission
issues a sentinel event alert for hospitals to improve medical
device alarm safety.
ECRI Institute. Strategies to improve monitor alarm safety.
Alarm fatigue sets off bells. Modern Healthcare
Alarm fatigue a top patient safety hazard. Canadian Medical
Association Journal
Over-monitoring and alarm fatigue: For whom do the bells toll?
Heart and Lung.
There are so many good sources!!!
5

Why are these Relevant?
These sources are directly relevant to why alarm fatigue is a
problem that is only getting worse.
How and why it effects healthcare.
Joint Commission reporting of such incidents that have been
directly related to alarm fatigue.
How to change the course of alarm fatigue.
Evidence based reporting and studies for reference support.
What is Alarm Fatigue?
Alarm Fatigue is care givers desensitized do to overwhelming
amounts of alarms.
The many “beeps, chimes and bells” are the reason for delayed
care and even death.
A 12 day study at John Hopkins determined over 350 alarms per
bed.
Over 80% are false alarms.
No standardization of alarm technology
The more false alarms the less likely someone responds.
(Jones, 2014)

Where do We begin?
Review the Joint Commission Reports
Speak to Safety Experts in Other Fields
Create a Culture of Safety
Leadership Buy In
Staff Buy In
Redefine the Framework
Trust, Report and Improve- Concepts
Have accountability for safety protocols
(Chassin & Loeb, 2013)
Joint Commission Reports
-566 Alarm Related Deaths Between 1/2005-6/2010
-Most Often Reported in ER
-85-95% Alarms are false
-The Many False alarms desensitize Staff
(Ed Manag., 2013)
Summary
The amounts of research and data available for alarm fatigue is
overwhelming. The data supports a overhaul of the technology
systems to become integrated with All of the vital sign alarms.
Also to have standards in place for baseline alarm settings.
Alarms should also be in reference to baseline health status of
patient to prevent false alarms. I still have a lot of work to

complete and will be ready to present next week!
Annotated Bibliography
Citing reports of alarm related deaths, the Joint Commission
issues a sentinel event alert for hospital to improve medical
device alarm safety. ED Manag. 2013;26(6)
This article from ED Manag, which was accessed from
PUBMED is a evidence based article that depicts the role of
new alarm technologies that are overwhelming to healthcare
providers. The Joint Commission has documented the amount of
deaths related to these such alarms. This evidence will prove
that alarm fatigue causes sentinel events.
Chassin, M. R., & Loeb, J. M. (2013). High‐reliability health
care: getting there from here. The Milbank Quarterly, 91(3),
459-490.
The Milbank Quarterly article on how to improve
healthcare safety and reliability. It explains how other
organizations for example: the airline industry, maintain safe
conditions with minimal adverse events. By examining the
processes of other industries can perhaps provide insight on
managing errors in healthcare. Within such industries there are
common factors influencing such gains: leadership, compaines
safety culture and effective process tools.
Jones K. Alarm fatigue a top patient safety
hazard. CMAJ. 2014;186(3):178. doi: 10.1503/cmaj.109-4696.
CMAJ address that alarm fatigue desensitizes health care
professionals and are the leading cause of technology hazards.
Deciphering through which of the alarms are actually
emergencies are the issue at hand. 80% of alarms are reported

as false. Different manufactures use multiple different alarms.
There is no distinguishing between sounds and this can lead to
ignoring and ultimately alarm fatigue.
McKinney M. Alarm fatigue sets off bells; Mass. incident
highlights need for protocols check.
ModernHealthcare.2010;40(15):14.www.modernhealthcare.com/
article/20100412/MAGAZINE/100409955. Accessed August
2018
Modern healthcare a leader in healthcare news and
research reported on a hospital in Boston that had a tragedy
with a cardiac patient due to desensitation of cardiac alarms.
The alarm had been turned to the OFF setting and for twenty
minutes the patients heart rate dropped to ultimately was unable
to be resuscitated. The horrible tragedy has brought about good
because now the hospital is applying the proper protocols for
alarms to be used in best practices for patient safety.
To be continued, edited and new sources added.
11
What is Philosophy?
LOVE OF WISDOM
The etymology of philosophy reveals that the word is derived
from the Greek ‘philosophia’:
Philo = loving
Sophia = knowledge or wisdom
So, we can understand ‘philosophy’ to mean the love of

wisdom, but this is not a very informative characterization.
A WAY OF THINKING…
When the word ‘philosophy’ is used in casual conversation, it
most often refers to a way of thinking, a deeply held belief, or
an ideological commitment of some type. You might hear
someone say:
“My philosophy is that we should live life to the fullest!”
Or:
“I tend towards a libertarian philosophy when it comes to issues
of personal freedom.”
A CONVERSATION THROUGH THE AGES….
Another way to understand the word ‘philosophy’ is as a
conversation that has continued across time, addressing
questions that matter to us, but that cannot be answered by
using our 5 senses to gather empirical data. For this reason,
philosophical questions have been a subject of thought and
conversation in all human populations throughout our history.
OUR QUESTIONS
Philosophical questions address many subjects. Some common
examples are:
Why is there something, rather than nothing?
Is the physical realm all that exists, or do transcendental
concepts like heaven, gods, and souls also exist?
Can we be certain that reality really is as it appears to us?
How should we behave and to whom are we morally obligated?
OUR QUESTIONS
What is the essential nature of personhood?
What justifies the state?

What type of political society is best?
Do human rights really exist?
Are all people equal?
How should we resolve our differences in society?
What is beauty and why are we inclined towards it in art and
music?
WHAT MAKES THESE PHILOSOPHICAL QUESTIONS?
The uniting characteristic of philosophical questions is that they
are ‘non-empirical questions.’ In other words, they are
questions that cannot be answered conclusively using empirical
data. This means that we cannot simply collect data through
observation and experimentation – no matter how much we
collect – and produce answers to philosophical questions that
are uncontroversial and for which a consensus can be achieved.
Since empirical data cannot assist us in philosophy as it does in
the sciences, we rely or reason and ideology.
THE ROLE OF REASON
Logic and reasoning are the primary tools of philosophy.
Reasoning is, of course, used in other disciplines as well.
However, reasoning is the sole basis from which a philosopher
draws conclusions. Due to this fact, reasoning well is important
to us. As such, philosophers beginning with Aristotle have
formulated systems of logic by which to study and understand
how to apply reasoning accurately. We make arguments to
support our conclusions and our arguments are evaluated
according to the quality of their reasoning.
THE ROLE OF IDEOLOGY
We must have a beginning point from which to reason to a
conclusion in making arguments. In philosophy, that beginning

point is very often an ideological claim. ‘Ideology’ refers to
fundamental beliefs that individuals hold with conviction. They
are those basic beliefs that many of us take to be the foundation
of our very identity. They are they things that we stand for as
individuals and fight for as societies. Humans quite often differ
in our ideological beliefs, though, and this is why we find a
variety of ways of living and thinking around the world.
EXAMPLES OF IDEOLOGICAL CLAIMS
Here are just a few examples of ideological claims:
Justice requires us to treat people as equals
Democracy is the best form of government
Freedom is worth dying for
Actions that are wrong are wrong for all people at all times
If a creature can feel pain, we are responsible for not
unnecessarily causing it pain
Everything happens for a reason
IDEOLOGICAL REASONING
Now that you know about reasoning and ideology, consider the
following argument that a philosopher might make:
1. Justice requires us to treat people as equals
2. Racial profiling does not treat people as equals
Therefore, 3. Racial profiling is unjust
To evaluate this argument, you would consider whether you
agree with its premises (1, 2). You would also consider whether
the premises, if true, really do support the conclusion (3).
Making and evaluating arguments in this way is the work of
philosophy.

PHILOSOPHY AS AN ACADEMIC DISCIPLINE
Having read the description of philosophy in this presentation,
you can probably see that philosophy happens in many places
and at any time. You can do philosophy in your own mind, by
talking with other individuals, by getting involved in political
activism, and by arguing for your ideas about the difference
between right and wrong. However, philosophy is also a formal
academic discipline.
THE FOUNDATION OF THE ACADEMY
In fact, philosophy is the founding discipline of the academy.
An ancient philosopher you may have heard of named Socrates
is considered to be the father of western philosophy. As a
politically disgruntled citizen of the city-state Athens in ancient
Greece, Socrates set out to discover who amongst the leaders of
Athens had the requisite knowledge of justice, the state, and its
proper function in order to rule effectively. His search for
knowledge and his political activism were perceived as a threat
by the aristocratic class of Athens and eventually, Socrates was
put to death.
Socrates had a student named Plato who was so incensed by his
mentor’s death that he set out to create a safe space in society
to pursue knowledge without fear of retribution. This was the
first school, as we understand it today. The Academy was held
mostly on a plot of land that had been willed to Plato and was
named after the Greek hero Academus.
HOW DOES PHILOSOPHY EXIST IN THE ACADEMY
TODAY?
Today, academia is comprised of many diverse schools and
disciplines. The philosophical foundations of academia can still
be seen, though, as the highest degree in many fields is the PhD
– the doctor of philosophy. In any discipline, once you are

engaged with the theory that guides practice, you are engaged
with philosophy. This engagement occurs in its fullest form at
the level of graduate study, but even introductory level students
are introduced to the theoretical foundations of disciplines and
are encouraged to evaluate them.
However, philosophy is also an academic discipline of its own
and so we find stand-alone philosophy departments in colleges
and universities around the world. In some departments, though,
philosophy is paired with religion or the fine arts.
A CONTEMPORARY CHARACTERIZATION
Today, we can say that philosophy is the academic discipline
that deals with non-empirical questions and their answers.
As has been discussed in this presentation, non-empirical
questions are those that cannot be answered conclusively using
empirical data.
Empirical questions, however, can be answered conclusively by
using empirical data and science deals with those with ever-
increasing effectiveness.
A FINAL NOTE
Be aware, though, that despite the fact that empirical questions
can be answered conclusively, science does not take itself to
ever offer ‘the final word’ simply because we are not
omniscient beings. Scientists leave open the possibility that
further data may arise which might require us to modify our
understanding of the world. It could be, then, that at least some
empirical questions will never be answered conclusively by us
due to the limited nature of our knowledge.
Claims arrived at through scientific research are considered
more or less certain to the degree that scientists believe further
relevant data might be discovered. As such, key ideological
beliefs such as ‘all things being equal, the future will continue
to be as the past has been,’ do affect how scientists understand

the natural world.
So, while we can distinguish philosophy from science as an
academic discipline, there are still important philosophical
issues related to science. These are addressed in the philosophy
of science.
FIELDS OF PHILOSOPHY
Metaphysics, Epistemology, Ethics, Applied Philosophy, Logic
Metaphysics is often called ‘first philosophy’ and, indeed, is a
foundational area of philosophy. Metaphysics asks and attempts
to answer questions about the nature of what exists. The reason
questions within metaphysics cannot be addressed within the
sciences is that metaphysics questions what might exist that
cannot be discovered empirically. However, before the methods
of science were developed, the best humans could do was to
reason about the nature of the world around them. For this
reason, questions that historically may have been addressed
within metaphysics are, today, left to scientists to address.

METAPHYSICS
A tendency we see throughout our intellectual history is the
desire to discover what constitutes the basis of reality. What
creates the objects of our experience? To what, if anything, can
all things be reduced? These were key questions for
philosophers in the ancient period, particularly the Presocratics.
Many were ‘monists’, meaning they believed a single element
must be the fundamental source of all things. Plato and
Aristotle, though, shifted the debate in metaphysics to a
question that is still relevant and central to philosophy today: Is
the natural realm all that exists, or does some transcendental
realm also exist?
ANCIENT METAPHYSICS
After the Roman Catholic church dominated the western world
for about 1,000 years, the age of reason, or the ‘Enlightenment’,
brought with it an explosion of intellectual activity. We see this
in the arts as well as in the sciences. During this time,
philosophers were more free than before to explore ideas about
the nature of reality. For this reason, we see grand metaphysical
schemas developed by philosophers such as Descartes, Locke,

Hobbes, Berkeley, and Spinoza – just to name a few. Many of
these ‘pictures of reality’ are discussed in an introduction to
philosophy class. It is a valuable intellectual exercise to
consider and evaluate these. They may even be understood as
works of art, of a type, insofar as they are creative and grand
descriptions that aim to explain the nature of reality.
METAPHYSICS IN THE MODERN AGE
As we progress into the contemporary period, the influence of
analytic philosophy and philosophy of language has a
significant impact on metaphysics. Many philosophers today
believe that reality just is what is described by scientists and
that analysis along with careful use of language helps us to
avoid confusions that, in the past, motivated projects within
metaphysics. Ultimately, though, we find that questions about
the true nature of reality remain central to human curiosity and
our answers to them form the core of our systems of belief.
Metaphysics Today
Epistemology is defined as ‘the study of knowledge.’ Questions
that are central to epistemology include:

- What is the nature of knowledge?
- How does knowledge differ from belief?
- Can we ever have certain knowledge?
- If we can have knowledge, what is its foundation?
Epistemology
During the ancient period, reason was understood as the path to
knowledge. Many of the Pesocratics, for instance, focused their
studies on mathematics and geometry. They believed that such
pursuits uncover fundamental truths and patterns of reality.
A notable view of knowledge in the ancient period was
advanced by Socrates and Plato and can be found in Plato’s
dialogues. According to them, knowledge is innate – it lies
within all of us – and it can be coaxed out through
conversations with a teacher or mentor. On this view,
knowledge is not something outside of us that we obtain.
Rather, it is something already in us that we discover.
Socrates and Plato on Knowledge
During the Middle Ages, also known as the ‘Dark Ages,’ a clear
preference for faith over reason in the pursuit of knowledge can

be found in the works of St. Augustine, St. Anselm, and St.
Aquinas. While they differed in their views on reason, they all
believed that faith was the foundation of knowledge of God. For
them, knowledge of God is the purest form of knowledge. Under
this system of belief, if reason cannot demonstrate the existence
of God, then so much the worse for reason.
Knowledge and the Church
With the onset of the Enlightenment came the dawn of the new
sciences. Francis Bacon advanced the scientific method and
intellectuals such as Kepler, Galileo, and Newton began to
uncover principles and laws of nature that any person could
confirm through the use of reason. No longer did man believe
that knowledge was out of grasp and so had to be arrived at
through divine revelation. The Enlightenment is marked by the
belief that, using reason, man can uncover the nature of reality
and create new and better ways of being.
The Enlightenment
Epistemology in the modern period centers on the debate
between rationalism and empiricism. Is reason or experience the
proper foundation of knowledge? In addressing this question,

philosophers made clear their preference for reason or
experience as our fundamental way of knowing the world.
Some, though, remained skeptics and believed that we can have
no certain knowledge.
The Modern Debate
The modern debate in epistemology is still relevant today, but
there is a new contender in the field. ‘Pragmatism’ is the only
philosophical view that is unique to the United States and it is
primarily concerned with the nature of truth and knowledge.
The pragmatist claim that ‘objective knowledge’ is not really
the aim of our pursuit. Rather, we seek what will satisfy our
curiosity and what will ‘work’ – in other words, truth is what
will allow us to function successfully.
A Contemporary Contender
Within the field of ethics, philosophers have historically sought
answers to questions such as:
- What is the nature of the ‘good’?
- What makes an action good?
- How can we distinguish good actions from bad

actions?
Ethics
In the ancient world, philosophers sought knowledge of virtue
and the good life. For them, ethics was very much about the
character of a person. Aristotle, for instance, believed that a
person may achieve eudiamonia (highest happiness) by living a
life of virtue guided by reason. For him, a person’s virtue is the
mean between two extremes of action (vices). Aristotle believed
that humans have unique functions – essential natures – and so
he believed that virtue is relative to the individual. What would
be brave for a soldier, for instance, would likely be foolish for a
merchant.
Ethics in the Ancient Period
During the modern period, we find that, for the most part,
philosophers abandon discussions of essential natures and
virtuous characters. We see a shift from focusing on the
individual within ethics to focusing on the nature of actions.
Contemporary ethics, as well, is centered on the question of
what makes an action good or bad. The essentialism of the

ancient period is abandoned after the Enlightenment so that we
can discuss individual actions and avoid the difficulty of
discussing ‘persons’ within ethics.
Ethics After the Enlightenment
When philosophy is applied, it results in practice. For this
reason, there are many different types of applied philosophy.
Popular types of applied philosophy include applied ethics,
political philosophy, philosophy of law, philosophy of science,
philosophy of language, and philosophy of race, class, and
gender. Applied philosophy seeks to uncover and/or advance the
theory that guides practice in these areas.
Applied Philosophy
Finally, logic is a field within philosophy and is, in fact, our
method. Since we deal in theory and ideology, our standard of
acceptance for a theory must be its appeal to our rationality. As
such, we want to ensure that we are reasoning well and that our
arguments do not contain errors. We also want to be sure that
we do not succumb to errors in reasoning. To achieve these
goals, Aristotle set out to uncover the structure of human reason
so it can be studied and improved. He produced the first system

of logic. We may define logic as ‘the theory of correct
inference.’ In other words, logic tells us when our reasons, if
true, support the claims they are meant to support.
Logic

ALARM FATIGUE in Nursing UniversityInformatics.docx

Recommended

Recommended

More Related Content

Similar to ALARM FATIGUE in Nursing UniversityInformatics.docx

Similar to ALARM FATIGUE in Nursing UniversityInformatics.docx (7)

More from simonlbentley59018

More from simonlbentley59018 (20)

Recently uploaded

Recently uploaded (20)

ALARM FATIGUE in Nursing UniversityInformatics.docx