Literature Review Of Alarm Fatigue

Literature Review Of Alarm Fatigue
Capstone Part I: Literature Review
Introduction to Problem Alarm Fatigue: According to Cvach (2012), alarm fatigue is "the lack of
response due to excessive numbers of alarms resulting in sensory overload and desensitization"
(Cvach, 2012, p. 269). Alarm fatigue is a major concern in the critical care unit. In a course of a shift
nurses hear so many alarms they began to become immune to them. There are many times when an
alarm sounds the result is often a false alarm. Research has demonstrated that 72% to 99% of
clinical alarms are false (Sue Sendelbach & Funk, 2013). As a result the increased number of false
alarms has resulted in alarm fatigue. Alarm fatigue is when a nurse or health care professional has
been exposed to an excessive number of alarms resulting in desensitization to alarms and missed
alarms. As a result there has been patient injuries and deaths associated with alarm fatigue. This has
raised concern making this a very important patient safety issue. Patient safety and regulatory
agencies have focused on the issue of alarm fatigue, and it is a 2014 Joint Commission National
Patient Safety Goal (Sue Sendelbach & Funk, 2013). This issue has raised many concerns and if not
handled in a correctly fashion could result in many more incidents and sentinel effects.
There are many ways that we as health care professionals can attack the problem at hand. First we
can start by individualizing patient parameters on the alarms. Not every patient is
... Get more on HelpWriting.net ...

Smoke Complaint Response Paper
Tier 1 – Volunteer Staff
Project title: Smoke Complaint Response
Lead Agency: Kittitas County Public Health Department
Partner Agencies: Local Fire Departments
Goal: Reduce the number of households with high opacity smoke emissions and improve burning
related behaviors in response to complaints.
Description: When KCPHD receives a complaint about wood smoke, letters are sent to the entire
neighborhood. This provides an educational opportunity to advertise the benefits of certified
woodstoves, establish clean burning practices and distribute relevant information to wood–burning
hotspots.
Project Methods:
1. Complaints received by phone or email at KCPHD are logged into an internal complaint tracking
system, CAMAS, by the complaint recipient.
2. Complainants are asked whether they wish to remain anonymous and contact information for the
complainant is recorded if appropriate. The name ... Show more content on Helpwriting.net ...
The specialist consults a county parcel map and establishes a target area for response that
encompasses the most houses in the immediate vicinity of the complainant.
5. Letters are sent to all residences in the specified area with clean burning information and
suggestions to limit smoke emissions along with information about available wood stove change out
programs.
6. Local fire department staff may become involved in the cases of repeat offenders and are able to
issue fines for egregious outdoor and indoor burning violations.
7. Once a complaint has been closed, the closing date is recorded. A complaint is closed when the
appropriate level of compliance has been achieved or the complaint has been passed on to the
appropriate county or city code enforcement personnel. Currently the air quality program at the
Kittitas County Public Health Department does not have regulatory authority to impose fines
without working through city or county code enforcement. If the issue escalates, Washington State
Department of Ecology is made aware of the situation through their AQ

False Medical Alarms
Multiple sources cite false alarms in anywhere from 72–99% of all alarms (Ensslin, 2014; Meeks,
2014; Sendelbach & Funk, 2013). Clinical alarms are in place to enhance patient safety by alerting
health care workers to deviations in predetermined normal status (Sendelbach and Funk, 2013), but
with up to 1000 electronic alerts and alarms each shift, it is difficult to know which alarms to
respond to (Duggan, 2016). In labor and delivery, two lives are depending on the nurse to know
which alarms are important to respond to. In addition to the safety of the patient, persistent alarms
affect the labor experience of the patient and family, contributing to increased stress and anxiety and
decreasing the holistic experience (Meeks, 2014). Many times

Alarm Fatigue : A Worldwide Professional Organization Essay
Alarm fatigue was brought into the spotlight in recent years because of adverse patient outcomes.
These sentinel events triggered the Joint Commission to make alarm safety a goal in 2014, and
mandating policies and procedures to be in place by 2016 for better monitoring and observance of
alarms. I decided to highlight this topic since a large part of a critical care nurse's daily routine is
silencing alarms for monitors, pumps, ventilators, beds and call lights. In my personal experience
inappropriately set parameters for monitors can lead to sensory overload for staff, patients and
families leading to a less than desirable work and care environment. In most cases false alarms can
be minimized with simple interventions, alerting staff to real situations requiring intervention.
Professional Organization: The American Association of Critical Care Nurses (AACN) is a
worldwide professional organization. It is comprised of two hundred and forty chapters in the
United States, China, Japan, and Germany along with armed service branches in the Pacific, Europe
and Middle East. I am familiar with this organization through their credentialing examinations for
CCRN/CMC/CSC for individuals, the standard for critical care credentialing. The AACN also
designates Beacon Awards™ to units that promote greater teamwork, lower turnover and higher
morale. I chose to go with an AACN journal because of their reputation and the quality of
knowledge they have afforded me over my career as a nurse.

False Alarm Creative Writing
False Alarm My lungs burned as I dashed vigorously through the streets of Venice. Although I had
only been living there for a few months, I knew it was a city I could call home. A cool breeze
replaced the warm, humid air of the shores. Clouds engulfed the city in a thick fog. The sounds of
ocean liner's foghorns bellowed in the distance, echoing in the silence of the sleeping city. The
waters in the narrow canals shimmered under moonlight. I sensed the movement of something
behind me, but I carried on without checking, too petrified to discover what it could be. I quickly
turned the corner into a dark alleyway in an effort to lose whatever was chasing me. Almost
immediately, I watched as a dark shadow crept into the alleyway in my direction. The hairs on the
back of my neck stood on end. The figure came closer and closer until I could smell the familiar,
musky scent ... Show more content on Helpwriting.net ...
He dragged me deeper and deeper into the alley so that the dark completely surrounded us. I kicked
and screamed, struggling to try to escape his firm grip. Becoming light headed, I screamed until I
had no more breath. I felt the feeling leave my arms and legs as I tried to take one last desperate
gasp for air. My effort was too little too late, and before I knew it, I had blacked out. I awoke to
bright lights, making it difficult to see my surroundings. I could feel the soft bed beneath me
forming to the shape of my body. The faint sound of a beeping heart rate monitor replaced the
silence of the room. As my vision cleared, I glanced upward to see a group of concerned doctors
conferring with one another. I tried to sit up, only to realize that I didn't have the strength to. I
became more confused and began to desperately ask the doctors questions. "What's happening to
me?" I cried in confusion. I received no response. Nobody acknowledged that I was talking aloud.
Frantically, I attempted to ask a second time. "Am I going to be

Roadside Construction Essay
Abstract
Due to the growing population and overly congested roadways, numerous of the roadside
construction sites occur at night to reduce the problems of traffic. These sites have continually
shown problems caused by their unnatural lighting solutions. The essential problem brought to
attention is that of safety, caused by the poor vision, bright lights, shadows, and the glare created by
the current lighting types being used. While looking at these different forms of lighting, one will be
able to see and understand which the best permanent solution for roadside construction is. Portable
Towers, Balloon Lighting, Headlights, Droplights/Floodlights will all be looked at as possible
solutions, as well as the advantages and disadvantages ... Show more content on Helpwriting.net ...
According to the Signal Detection Theory (SDT), in these events, I would be considered a miss.
(Foley, 2010) I am driving through and because the lighting is so strong or so poor, I miss the
workers instructions and sometimes even the workers themselves. I also have seen sites where I can
see the workers fine but it seems like they cannot see the vehicles approaching, which will also be
considered a miss according to the SDT, (Foley, 2010) which can be warning signs for a possible
future serious accident and exponential problems. When one cannot see the workers instructions
clearly, it is very easy to mistake what they say, thus causing a false alarm. (Foley, 2010) According
to the SDT, in this case would be a mistake what you see or hear on the roadside due to the poor
lighting conditions (Physical Stimulus) that cause one to perceive something incorrectly. (Foley,
2010) The problem we are looking at now is the insufficient amount of lighting on roadside
construction sites. Most of the time these construction sites have workers working late at night well
into the early morning, (Huckabee, 2009) which in this case is an example of top down processing.
(Foley, 2010) The physical stimulus, which is the lighting issue, is not sufficient to determine the
perception of the light. The mental factors play an essential

Alarm Anxiety Of Alarm Fatigue
Hospitals are chaotic and can be difficult places to maintain safety if precautions aren't taken. One–
way that healthcare providers attempt to combat safety issues is by using different alarm systems to
alert staff to issues in patient rooms. The many different alarms can be beneficial but can also cause
a phenomenon that is referred to as alarm fatigue. Alarm fatigue is defined as a condition of sensory
overload for staff members who are exposed to an excessive number of alarms (Blake, 2014). It is a
national problem and the number one medical device technology hazard in 2012. The problem of
alarm desensitization is multifaceted and could be attributed most heavily to high false alarm rates.
Studies have indicated that the presence of false and/or clinically insignificant alarms ranges from
80–90% (Cvach, 2012). The constant alarms make it difficult for nurses to discern the difference
between emergent and annoying alerts and can cause many to not respond as urgently as necessary.
Background
I had a personal experience with the effects of alarm fatigue this semester. I was working with an
RN who graduated from JMU in 2010. We had multiple difficult patients whom would ring their call
bells or mess with their equipment every chance they got. The nurse seemed annoyed with the
alarms and began responding more slowly and silencing alarms. After lunch, I went to check on my
patient and saw multiple nurses in her room. A tech told me that her IV had infiltrated and nobody

Improving Clinical Alarm Safety Care Delivery Systems
Improving Clinical Alarm Safety
The topic I have chosen for my Portfolio Project is "Improving clinical alarm safety in hospitals."
As a member my organization's Quality Improvement Team, I have been recently involved in an
initiative to establish "alarm safety" as a priority for leadership of our hospital. My interest in the
success of this initiative stems from a strong desire to be involved in the development of "safe"
patient care delivery systems. As I research this topic and "problem" further, I will be examining the
various published recommendations and best practices, proposed by various healthcare safety
organizations, to develop processes for safe alarm management in high risk areas of the hospital. I
will also propose ... Show more content on Helpwriting.net ...
Many of these alarms do not require that a medical intervention be performed, and nurses and other
patient care providers can become overwhelmed by the volume of alarms they must respond to.
Clinicians report being desensitized or immune to the signals over time, sometimes inappropriately
turning down the volume or adjusting the settings outside of "safe' limits. These situations can result
in serious consequences, including death. The Joint Commission Sentinel Event database contains
98 reports of alarm related events between January 2009 and June 2012 (TJC, 2013). Patient death
was the end result in 80 of these events. In addition, the Food and Drug Administration (FDA)
database contains 566 alarm related patient deaths in a four year period, between January 2005 and
June 2010 (ECRI, 2013). In a survey of hospital leaders conducted by The Joint Commission in
2012, fewer than 50 percent had an organization–wide process for alarm management.
Identified Patient Risks
Nurses often compare their patient care environments to a casino or carnival; a cacophony of sounds
and little distinction of where these sirens originate and what they mean (Cadet, 2014). Clinicians
cope by turning alarms down or off to create a more tolerable environment for themselves and their
patients. Unfortunately, all too often this results in harm to the patient. In a recent survey by the
Health¬care Technology Foundation (2011), one in five respondent hospitals identified an avoidable

Alarm Problems Going Off in the Intensive Care Unit
Opportunity
There has been a great deal of recent work surrounding the issue related to alarm fatigue in clinical
settings. The Joint Commission (JACHO) has identified the importance to tackling the security of
alarm systems. There have been many reported deaths related to the absence of attention to cardiac
monitors (JACHO, 2013). A new patient safety goal for 2014 goal is to improve the safety of
clinical alarms. Emergency Care Research Institute (ECRI) has listed the alarm hazards as the
number one health technology hazard for 2014 (ECRI Institute, 2013). The ECRI endorses the
implementation of interventions to minimize the number of insignificant alarms. The goal is to
create an environment that promotes awareness to alarms that are actionable.
In the intensive care unit, several alarms ring at any given moment. Many times the alarms cannot
be heard when nurses are busy in other rooms. Additionally, there are a high number of alarms that
are false and create much nuisance noises. Nurses work in a loud environment. Responsiveness
becomes difficult when an individual's auditory system is overloaded with multiple sources of
alarms. Providing the appropriate attention to the cardiac monitoring system becomes a challenge.
This scenario represents an opportunity to improve the quality of care that is given in the intensive
care unit. This paper will review the development process in the intensive care unit related to alarm
management.
Change Proposal The

Tank 912
3) What was the cause of the accident?
Systems in place to monitor and regulate filling of tank 912:
Equipment:
The tank had two forms of level control: an automatic tank gauge (ATG) that enabled the employees
to monitor the filling operation; and an independent high–level switch (IHLS) which was meant to
close down operations automatically if the tank was overfilled. TAV Engineering Ltd supplied the
IHLS to Motherwell Control Systems Ltd who installed the switch and preformed routine
maintenance but both parties fell short of what was expected for such a high–hazard environment
and did not properly communicated that the IHLS needed a padlock to lock it in the operating
position. This was overlooked as just a lock for security and was not ... Show more content on
Helpwriting.net ...
This was unknown to the site operators and as soon as the call came in alerting of the massive
vapour cloud which was forming the fire alarm was activated, which sounded an alarm and started
the fire pump. Almost immediately causing a 'vapour cloud explosion' probably ignited by a spark
created by the fire pumps starting. (COMAH, 2005)
Failure of design:
Having failed to contain the product within the storage tanks, there was reliance on a bund retaining
wall around the tank (secondary containment) and a system of drains and catchment areas (tertiary
containment) to ensure that any liquids did not find their way into the environment. Both forms of
containment failed. Pollutants from fuel and firefighting liquids leaked from the bund, flowed off
site and entered the groundwater. These containment systems were inadequately designed and
maintained.
References
COMAH. (2005, December 11). hse.gov.uk. Retrieved from Health and Safety Executive :

monitor alarm fatigue Essay
Strategies to Reduce Monitor Alarm Fatigue
Courtney Conner
University of South Alabama
Strategies to Reduce Monitor Alarm Fatigue
Monitor alarms are designed to alert caregivers to changes in a patient's condition and can save
lives, but majority of the alarms do not require clinical intervention. However, as the number of
alarms encountered by clinicians on a daily basis rises, it has become difficult for caregivers to
distinguish between clinically significant alarms and nuisance alarms. As a result, alarm fatigue has
become a serious issue, which puts patients at risk. The purpose of this paper is to discuss the
research findings of two articles to explore more efficient and effective methods to reduce nurse
desensitization to clinical ... Show more content on Helpwriting.net ...
The findings found that nurses felt irritated with inappropriate alarm settings and the high volume of
noise on unit, resulting in delays in response times. False alarms were the main culprit in the nurses'
opinions. The interventions supplied by the article were individualizing alarm limits, buddying
systems, a charge nurse making rounds, and the development of smart alarms with algorithms that
cover multiple conditions (Christensen et al., 2014). In Cvach's (2012) article, an integrated review
synthesized research and non–research findings of seventy–two articles, published between
1/1/2000 and 10/1/2011. The author used the John Hopkins Nursing Evidence Based–Practice model
to measure and evaluate the articles for this review. The data collected were categorized into 5 main
themes: excessive alarms and the effects on nurses, nurse's response to alarms, alarm sounds and
audibility, technology to reduce false alarms, and alarm notification system (Cvach, 2012). The
purpose of this integrated review was to find out if the volume of noise (false alarms vs true alarms)
disrupts the nurse's response and perception to physiologic clinical alarms. The 3 main
recommendations provided by the researcher were to implement the use of smart technology,
generate change within the hospital's environment and protocols, and use of precautionary measures
by healthcare staff in order to reduce monitor alarm fatigue.
Level of Evidence and Grade of Recommendation According to the

Summary: The Informatic Nurse Specialist
Expected improvements as outcomes.
Employing teamwork to combat the problem and consequences of alarm fatigue is crucial in the
safety of patients. The Informatic Nurse Specialist along with the nurse manager and alarm
committee will individualize and customize alarm thresholds to limits that are clinically appropriate
for individual patients to decrease the incidence of nuisance and false alarms that distract staff
members and contribute to alarm fatigue ( Cvach,2012; Evans,Shumante & Lovelace, 2011). Staff
will be re–educated on the appropriate use of alarm systems to help minimize the effects of nuisance
and false alarms. When staff are appropriately trained on how to fully utilize equipment, clinically
signicant ... Show more content on Helpwriting.net ...
It is important to note that the implementation of health information technology should not add to
the operational burden on the nurses but provide for improvements in patient care (Jacques&
Howell,2015). Clancy states," that the nurse informaticist play a vital role in the successful
planning,design and implementation of information technology" ( 2015, p.535). The selection of this
new upgraded software will be easily configured and maintained by the IT department. The nurse
informatics specialist will assist with the design and implementation of an app system that integrates
to an upgraded electronic health record ( EHR) that will display crucial patient information and vital
alarm information to the healthcare providers healthcare certified mobile phone and also a
centralized dedicated alarm monitoring area in the nurses station. This upgrade in the EHR will
provide easy accessible information to help providers to prioritize patient needs as urgent and
critical vs noncritical and can wait. The use of mobile devices displaying patient critcal information
enables staff to effectively communicate and collaborate with other members of the health care team
to respond to a crisis because of an actual life–threatening actionable alarm event. The use of this
enhanced, upgraded EHR not only assist health care providers to prioritze actions and react more
proficiently to alarms but it will also help to determine the appropriate treatment plan for the

Research on the Logistics and Mechanisms of Attention
Attention is a mechanism directly involved in the selection, distribution and maintenance of
processing resources, which determines our ability to process complex and multiple stimuli from our
environment and is crucial to our success and survival. Given the large magnitude of visual
information we encounter every day, the existence of a selective mechanism –at a conscious and
unconscious level– that regulates what we pay attention to is indisputable; it has even been
conceptualized as a supramodal mechanism that distributes cognitive resources according to task
complexity and motivation (Salthouse , Rogan & Prill , 1984). Initially conceived as a single
spotlight alternating amongst foci (Tiffin, Knight & Jackson, 1946), attention is now understood to
be beneficial due to its capacity to divide. Nevertheless, there is a limit in scope and manner, so we
are constantly promoting the priority processing of certain information in the presence of multiple
stimuli (Rosselló, 1999). Understanding the logistical constrains behind this prioritization and
allocation of resources is thus important from a theoretical perspective (Vergauwe et al., 2010), but
also due to its practical implications in various fields such as the military, sports, transportation,
safety and education (Strayer & Johnston, 2001; Gingerich & Lineweaver, 2014).
Generally, these constrains have been studied in two specific domains: space and time. Regarding
space, visual search paradigms explore how stimulus

Vender Safety Case Study
these guidelines to be instrumental in helping members of the healthcare community and recognize
clinical alarm safety as a systemic multipronged issue that requires the implementation of innovative
alarm management strategies. This documented strategy includes a methodical approach to
intelligently reduce alarms and creating a multilayer alarm notification system. Cvach's (2012)
established guidelines has led to strong adoption of an effective alarm management strategies and
supporting innovative technological solutions. The clinical teams have incorporated nationally
recognized best practices and guidelines in developing an alarm management solution for the NICU.
Vendors Technologies
Mobility Applications. After having a clear ... Show more content on Helpwriting.net ...
Webb (2017) stated that the competing middleware vendor Extension recently acquired a mobility
platform named Vocera. Although Vocera was considered as a mobility, communication platform,
COHC has made a significant investment with the use of the Apple iPhone and therefore the use of
Vocera would be a costly change in direction. Ouellette (2017) and Webb (2017) agreed that the next
step would be to explore the medical equipment integration capabilities of Connexall's alarm
management middleware solution.
Medical Equipment Interoperability. The project team evaluated the five primary types of medical
equipment systems that were determined that interoperability would be critical by NICU clinicians
for effective communication. Ouellette (2017) investigated critical medical equipment to determine
the feasibility for integration with alarm management middleware and mobile applications. The
NICU clinical team identified the Phillips patient monitoring, pumps, incubator, ventilator and the
nurse call as medical equipment that is vital to their workflow.
Physiological Monitoring. The Philips patient monitoring system can be centrally managed and has
the ability to send patient alarm data from the medical device via a transmission protocol to the
middleware alarm system. The system also has localized visibility and audible sounds on the local
patient monitor inside the patient room

Dna Testing And The Criminal Justice System
Convictions prior to the advancement of DNA testing in the criminal justice system were commonly
found to be later wrongful and due to eyewitness misidentification (Scheck & Neufeld, 2001).
Hence, there has been increasing research by psychologists in eyewitness memory and particularly
in line up practices. In criminal identification, a simultaneous line up (SIM) is typically used and
involves presenting the witness with all line–up suspects at once with the offender (target) placed
amongst other innocent suspects (foils) that resemble the offender (Wells & Olsen, 2003). With
these conditions, witnesses have a tendency to compare suspects with each other in order to
determine the one that have the closest resemblance with the offender, a process called relative
judgement (Steblay, Dysart, Fulero & Lindsay, 2001). In the simultaneous line–ups with target
present, there are more hits as the closest resemblance is the perpetrator but while in target absent
conditions, the closest matching foil is often picked and resulting in more false alarms (Steblay,
Dysart, Fulero & Lindsay, 2001). Therefore, to prevent the potential of misidentification, alternative
line–up presentations have been developed to inhibit relative judgement processes such as sequential
line–up in Lindsay and Wells (1985). Sequential line–ups (SEQ) involves presenting a line–up of
photos in a sequential format and eyewitnesses can only view the photo once and must determined
whether the photo matches the

Description And Scope Of The Problem
Section I: Description and Scope of the Problem Universally, across international acute care
organizations with a vested interest in healthcare safety, there is recognition that clinical alarm
systems pose a hazard to patient safety (TJC, 2014; Lukasewicz & Anderson, 2015). The Joint
Commission (TJC) issued a Sentinel Event Alert in 2013 on device alarm safety which subsequently
led to the creation of the National Patient Safety Goal 06.01.01 (TJC, 2014). The alert and goal was
published with an aim at acute care hospitals because of reported adverse and sentinel patient events
and data that related to the nature of these events, indicating there is significant risk related to
clinical alarm systems. The NPSG 06.01.01 is a requirement ... Show more content on
Helpwriting.net ...
Lukasewicz & Anderson (2015) state there is literature that supports major themes which have been
linked to clinical alarm events as studied by various patient safety organizations, some of which
include: The Joint Commission, ECRI Institute, and The Association for the Advancement of
Medical Instrumentation, all of which noted the problem to be complex. According to TJC (2014),
the purpose of clinical alarm systems is to give a warning to caregivers that a problem exists. If the
alarm warning is not provided, not perceived or is mismanaged, the consequence can lead to an
adverse and/or sentinel event. There is a plethora of contributing factors for alarm mismanagement,
making the problem complex to understand and solve. Alarm failure can result from decreased
detectability, excessive alarms, desensitization causing missed or ignored alarms, default and alarm
parameter settings that are not appropriate for the clinical context and device design flaws (TJC,
2014; Lukasewicz & Anderson, 2015; XXX).
In order to address the multitude of clinical alarm hazards, many organizations recognize that nurses
are most directly impacted by clinical alarms, which include expectations for responses to alarms,
attitude and behavior in response to alarms, administrative support, all of which have been studied
extensively by various organizations involved in patient safety and by medical researchers
throughout the world (XXXX). As a result of this

Eyewitness Identification And Eyewitness Fingerprints
Eyewitness testimonies provide crucial evidence in pinpointing the identity of the perpetrator in
order to solve a crime, thus the criminal justice system depends upon the accuracy of eyewitness
identification to investigate and prosecute criminals. However, eyewitness identification is imperfect
and the leading cause of wrongful convictions (Huff, Rattner, & Sagarin, 1996; Scheck, Neufeld, &
Dwyer, 2000). One prominent method of eyewitness identification is a line–up procedure during
which "A line–up is a procedure in which a criminal suspect (or a picture of the suspect) is placed
among other people (or pictures of other people) and shown to an eyewitness to see if the witness
will identify the suspect as the culprit in question" (Wells ... Show more content on Helpwriting.net
...
Lindsay and Wells (1985) devised an alternative line–up presentation procedure to reduce the
tendency of eyewitnesses to rely on relative judgment. A Sequential Line–Up (SEQ) presents the
eyewitness with only one suspect at a time and they respond to each suspect with either a positive
identification or none (Wells & Olson, 2003). It was proposed that reasoned that this procedure may
raise participants' response criterion and evoke a more "absolute" criterion (i.e., Is this the
perpetrator or not?) rather than the similarity based relative–judgment criterion, thereby alleviating
the simultaneous bias (Ebbesen & Flowe, 2002; Lindsay & Wells, 1985). To compare the SEQ and
SIM line–ups Lindsay and Wells (1985) used two conditions; a target–absent line–up, in which one
an innocent suspect is embedded among fillers, and a target–present line–up in which the guilty
suspect is embedded among fillers. This data found that the SIM and SEQ procedures produced
nearly identical correct identification rates in the target–present trial whereas in the target–absent
condition the rate of mistaken identifications the rate was 43% with the SIM procedure and only
17% with the SEQ method (Lindsay et al., 1991). Compared to SIM presentation, SEQ line–up
presentation did not significantly influence the correct identification rate but

Plan of Action: Monitor and Alarm Fatigue
Monitor fatigue has been an issue ever since the technology to monitor patients was developed. The
problem has gotten worse as technology has advanced and the number of alarms in the hospital
increased. The average ICU has "over 40 different alarms" (Sendelbach & Jepsen, 2013). Monitor
fatigue is related to any type of monitoring device used in the hospital making the scope of the
problem rather large as monitors range from bed alarms to telemetry monitors. In June 2013 the
Joint Commission approved new "National Patient Safety Goal NPSG.06.01.01 in clinical alarm
safety for hospitals and critical access hospitals (The Joint Commission, 2013, p. 1)." One of the
first goals of the hospital was to identify the alarms most at risk for ... Show more content on
Helpwriting.net ...
Your paragraph(s) should be professionally written, single spaced with APA formatted citations and
references (there is a reference textbox at the end of this form. Use it for your references).
Nurses are so inundated with various buzzes and beeps from numerous alarms that they sometimes
are desensitized, and nurses to alarms fail to respond to alarms in a timely manner if they respond at
all. This is called alarm fatigue. Nuisance alarms are often called false positive alarms and are one of
the leading causes of alarm fatigue. These alarms normally do not result from a patient having an
adverse condition are often considered annoying because they get in the way of patient care
(Graham & Cvach, 2010). Basically, alarms go off falsely so often they have created a "cry wolf"
effect as caregivers start to mistrust the alarm system (Cvach, 2010). As stated previously, alarms
fatigue is a large problem with such huge risk to patient safety that The Joint Commission made
clinical Alarm Safety one of their Goals for 2014.
What are the implications of the problem? What will happen or not happen if the problem is not
resolved? Write 1–2 paragraphs discussing the implications with supporting examples. Your
paragraph(s) should be professionally written, single spaced with APA formatted citations and
references (there is a reference textbox at the end of this form. Use it for your references).
With alarms going off constantly, it is easy for a nurse to become

Atlanta Alarm Research Paper
Atlanta Alarms refers customers and clients to Alarm systems security providers in the Atlanta area
that will not let you down because security is something to be taken with deadly seriousness. Atlanta
Alarms strives to bring you services that detect, protect, and prevent the criminal activity you would
like to deter from entering your safe space. We detect with a wide range of IP Cameras, either
immobile or panning cameras that can be customized to our customers liking. Preventing crimes for
some homes and businesses is as easy as employing an automated gate, opening and closing the
flick of your wrist you'll be taken with all of our preventative services done through the best security
companies in Atlanta. The automated security services ... Show more content on Helpwriting.net ...
Digital images and other data are far easier to store using one of these systems. Surveillance systems
that our providers' offer means that they are monitoring their own homes without being seen use one
of the spy cameras offeredin tandem with our DVR recorders for video monitoring.Themonitor
allows you to view the output from several cameras at the same time.The connectivity of these
services provides the customer the added security benefit.
Remote Home security services offered through Atlanta Alarms security providers' offers a solution
for residents to quickly and easily arm their home security alarm system by simply pushing a button
no matter what the distance.. Remote home monitoring can be triggered by a phone call made
directly to your cell phone that alerts that alerts when something has gone wrong in the home.
Professional remote automation services ensure you will receive messages and alerts while the
authorities are

Installing A Home Security System
As a former Alarm Dispatcher with seven years of experience, I have a lot of knowledge regarding
alarm systems. You may be wondering whether or not a burglar alarm system is right for you. Here
are some things to keep in mind: A burglar alarm system on a business will lower your insurance
rates and will alert you any time the alarm sounds. There are also additional benefits of alarm
systems, such as schedules. Schedules are set by you, usually within business hours. Whenever the
system is not disarmed in the morning or not armed at night, the alarm company will call to let you
know. This ensures that your business is open on time and the alarm system is armed each night.
And each time someone disarms the system outside of those hours, the ... Show more content on
Helpwriting.net ...
Securing your home helps safeguard your valuables and keeps burglars out. What are some simple
home security measures you can implement today that will not break the bank? Secure the Garage
Door If you drive around the block, you will likely see garages that are left wide open, or just
partially cracked open. Unless you are inside the garage and can see what is going on around you, it
is never a good idea to leave the garage open, as it is an open invitation for thieves to just walk right
into your home without having to break a window. Bar Entry through Sliding Glass Doors If you
have sliding glass doors that lead out onto the patio or the back garden, this could be used as an
entry point by burglars to enter your home. Keep sliding glass doors securely locked at all times and
place a patio door security bar across the bottom of the sliding glass doors to keep would–be
burglars out. Choose a good quality product that locks into place when you install it so that it cannot
be manipulated by someone who is trying to gain unlawful entry. A simple lock can easily be opened
using a crowbar, but a bar can make it harder for intruders to break in. Install a Deadbolt Lock A
deadbolt lock will generally cost more than a patio door security bar, but it can give you peace of
mind from intruders. You can find a deadbolt for as little as $50 to over $100, depending on your
budget. Look for deadbolts that

Grey Wolf Research Paper
Grey wolves are unique and beautiful creatures that are a major part of everyday life in the woods,
or anywhere in the wild really. They closely resemble dogs, and are part of the same family, and
even act like dogs when young, but they are not dogs. When they are young, they will chew on
bones, play with other pack members, and even play with each other if they're bored or hyper
enough. When the pups reach 3, they can either leave the pack to make their own, or stay. If they do
decide to leave, they can be killed by other wolves, coyotes, or hunters waiting for them to take a
wrong turn in the woods. Each wolf, when they're an adult, can reach up to 3–5 ft. in body length,
and their tails can be 1–2 feet long! The average female weight is ... Show more content on
Helpwriting.net ...
They have been known to raid coyote dens and kill the pups, even though they are rarely eaten.
There is not a single record of a wolf being killed by a coyote, but they can bang together and chase
down a lone wolf if they are vulnerable. There are many diseases wolves can carry, like rabies,
canine distemper, canine parvovirus, infectious canine, hepatitis, papillomatosis, and canine
coronavirus. If a wolf is infected with something, they will show no fear, even towards humans, and
will attack. Most attacks are because a wolf has rabies. Bacterial diseases carried by grey wolves are
brucellosis, leptospirosis, Lyme disease, tularemia, anthrax, foot and mouth disease, and bovine
tuberculosis. Leptospirosis can be gotten from infected prey, and can cause a list of things, like
vomiting, fever, anorexia, and things to that scale. Aesop featured wolves in his tales, and his most
famous is The Boy Who Cried Wolf, which is a story about a boy who is told to watch sheep, and
after many false alarms, a wolf comes along and eats the sheep. The term "to cry wolf" is derived
from this tale, and it is directed at people who purposely raise false alarm. In the story Little Red
Riding Hood (written by Charles Perrault), it is said to have a bigger impact on wolves appearance
than The Boy Who Cried

Essay on Alarm Fatigue
Alarm Fatigue Alarm fatigue is a growing national problem within the health care industry that links
medical technology as a serious hazard that poses a significant threat to patient safety within
hospitals across the country. Alarm fatigue occurs when nurses encounter an overwhelming amount
of alarms thus becoming desensitized to the firing alarms. Alarm desensitization is a multifaceted
issue that is related to the number of alarming medical devices, a high false alarm rate, and the lack
of alarm standardization in hospitals today (Cvach, 2012). Desensitization can lead to delayed
response times, alarms silenced or turned off, or alarms adjusted to unsafe limits, which can create a
dangerous situation for the patient. Alarm fatigue ... Show more content on Helpwriting.net ...
378). Hospitals have an array of medical devices at the bedside that have alarms, which have grown
significantly within recent years. Nurses may be exposed to over 350 physiologic alarm monitors
per day, resulting in sensory overload thus leading to desensitization. When the alarm sounds it
should be corrected immediately, even though it may be a false alarm or no issues with the patient.
The Joint Commission has identified alarm fatigue as a 2014 National Patient Safety Goal, requiring
hospitals "to establish improvement of alarm system safety as an organization priority" (as cited in
Horkan, 2014, p. 83). Alarms are deliberately designed for high sensitivity so that nurses do not miss
a true event. Firing alarms are usually muted, disabled or ignored by nurses altogether because
alarms are viewed as a nuisance. Alarm hazards have generated national attention, in one highly
publicized case an alarm sounded for 75 minutes before a nurse responded to a patient's heart
monitor that needed a battery replaced. When the nurse finally went to change the battery the patient
was found unresponsive and could not be resuscitated because he had gone into cardiac arrest
(Sendelbach & Funk, 2013). The patient's heart monitor battery eventually died and did not issue the
critical alarm alert. In another event, a patient fell getting out of bed and bleed to death because the
nurse

Descriptive Essay On Auto Alarm In My Day
Cheesy Mozzarella cheese mixed in with cheddar jack, sausage gravy, sausage crumbles, and bacon
crumbles all smothered together on a freshly made pizza dough crust. Take a second to imagine its
warm and toasted beauty in nature. What about warm smothered biscuits with a middle layer of
sausage drenched in sausage gravy served in perfection of a non–mess bowl with a ice cold caramel
macchiato. If you are a pumpkin kind of person, just imagine how delicious a stuff pumpkin
cinnamon flavor pretzel served fresh the minute the Quik Trip kitchen opens. I am always
surrounded by the beautiful delicacy of food, in its all shapes flavors and sizes. However that just
the first thirty minutes of my day, my alarms are the beginning point and from then ... Show more
content on Helpwriting.net ...
I am also not interested in energy drinks, shots or any energy source of substance, they just don't
seem to take any effect on me. Anyhow, usually around this time I am setting up and stocking all the
back stock around the store. My motto is the lower the product is, the more poor we look so, I like to
keep my end of the shift full to the absolute maximum and have no outs, it just makes everything
look nicer. After shocking everyone with my hair down I decided to put it up in a pony like I usually
do... I have the kitchen shift. Meaning I still have to cook for my whole eight hours that I work. We
cook anything from drinks with ice cream to fresh flatbreads, shakes, frape's, pizza and now the new
item on the menu; Biscuits and Gravy. I am Definitely not a fan of it. Making fresh pizzas on the
hour is one of the kitchen's requirements, no exceptions. The pizza that's made until 10 am is the
breakfast pizza. I seriously can't even begin to imagine how many slices of pizzas we sell. After 10
o'clock, the pizzas that are served are three meat and pepperoni, And let me tell you they sell. There
are several duties that have to be done when you're on kitchen duty. Along with making and
prepping food you also have to write your food order.
As much as I love learning by just being thrown to the wolf's den, I have to say I didn't see this one
coming. I guess I should go to our store meetings at least once in a blue moon. I had to make the
newest dish offered in

The Prevention Of Neonatal Health Care Providers
Neonatal health care providers do their best to ensure the environment where the tiniest of patients
need to grow emulates the dark, muted place that they were used to. However, these patients are the
ones that need high–tech equipment to assist with their care. This equipment comes with many
different audible indicators meant to assist the bedside clinician in keeping these patients safe. These
sounds contribute to the noise level in the environment meant to heal. Amidst the worry about
patient's exposure to what many times is too loud noise, health care providers, too, are exposed to
the constant cacophony of bings, beeps, and bells. The Joint Commission designated a patient safety
goal recognizing alarm fatigue as of January 2014, and ... Show more content on Helpwriting.net ...
Many factors build that significance. In the article, "Monitor Alarm Fatigue: An Integrative
Review", the author describes five themes from research gathered:3 (Cvach, M.) 1. Excessive
alarms and effects on staff 2. Nurse's response to alarms 3. Alarm sounds and audibility 4.
Technology to reduce false alarms 5. Alarm notification systems A brief summary of this article
follows. The sheer number of alarms can be overwhelming. The majority of these alarms are not
valid or significant and can be termed as nuisance alarms. These can disrupt patient care and
decrease caregiver trust. The continued exposure to these types of alarms makes for caregivers that
may become desensitized. This desensitization could be potentially harmful for the patient if an
alarm is not taken seriously or alarm parameters are changed outside of set boundaries. Caregiver
response to alarms can be affected in various ways. Trust in the alarm system will encourage an
appropriate response. Perfecting different alarm sounds to enable the caregiver to hear it amidst all
of the other noise is ongoing. Alarms that are more significant may have a different tone or rhythm
that assists the caregiver in differentiating those that are more urgent or higher priority. "Adding
short delays can significantly decrease the number of ignored or ineffective alarms." Central
monitoring or a designated staff member to watch monitors has been implemented in many different
settings. There aren't many

Security Systems And Monitoring Fees
Safety in any home is a very serious subject.All options should be taken in to consideration. Here
are but three security systems to consider, with varied options to suit your personal needs.
Skylink SC–100 Security System Deluxe Kit
It is the answer to contractual monitoring companies and associated monitoring fees when it comes
to home security. It is a 4 zone system with house around 3000 sq. ft. in mind. Apartments, condos,
businesses and offices would do well with this system. Rolling or hopping code eliminates false
alarms and restricts access from unwanted listeners that can capture and use your personal security
code by recognizing radio waves on from its sensors. The front door can be covered with included
sensors. Also it includes a handy key for remote with 100 foot range so you can sensor. The 110dB
siren pierces the night when it is activated, scaring off intruders. Chime, Instant, and Delay modes
are options in the programmable Lighted keypad so it helps cut the time of set up. Customers rave
over the loudness of the product. It is a clear piercing siren sure to paralyze intruders in their tracks,
and ward off repeat visits. With it being tamper resistant the safety of wireless connections diverts a
line being cut by intruders.
Fees can get overwhelming when adding features to a monitoring contract. This is a onetime cost
and well worth the price with no monthly fee to contend with. It has Easy mounting with install
screws, and double–sided adhesive for

Alarm Fatigue : A Critical Problem
Alarm fatigue is a critical problem in health care setting. Nurses may not respond to alarms because
they know that most of them are false or non–actionable. Sometimes, the alarms become the noises
that nurses no longer hear because they are heard all the time. In addition to ignore alarms, nurses
may also reduce audible alarm levels, change alarm limits, and inappropriately silence or deactivate
alarms (Cvach, 2012). The alarm fatigue has led to sentinel events and deaths of patients (Cvach,
2012). Therefore, the alarm fatigue problem has to be fixed in order to improve patient safety. This
paper will introduce interventions based on evidence–based practices and leadership theories related
to alarm fatigue prevention.
False alarm is sometimes driven to unsafe actions. The nurses who must repeatedly respond to every
single alarm which are mostly false leading to alarm fatigue and ignore to respond true critical alarm
(Solet,& Barach,2012). The excessive alarms in patient care are distracting and interfering with the
ability of the nurse to perform patient care tasks (Solet,& Barach,2012). When there are excessive of
false alarms the clinicians adapt to response less or react with less urgency (Solet,& Barach,2012).
Ignoring alarm can cause serious harm or death to the patients (Cvach, 2012).
Many factors contribute to alarm fatigue; however, most significant is a false alarm rate which
reported as high as 83–85% (Solet & Barach, 2012). Some other

Electronic Detection Systems Is High Rate Of False Alarms
As computer attacks are becoming more and more difficult to identify the need for better and more
efficient intrusion detection systems increases. The main problem with current intrusion detection
systems is high rate of false alarms. Distributed Denial of Service (DDoS) attacks are large–scale
cooperative attacks launched from a large number of compromised hosts called Zombies, Which are
a major threat to Internet services. Therefore, keeping this problem in view here presents various
significant areas where genetic algorithm techniques seem to be a strong technique for detecting and
preventing DDoS attack. Our purpose of this work is to examine how to integrate multiple intrusion
detection sensors in order to minimize the number of incorrect alarms.so a brief introduction to the
parameters and evolution process of a GA will be provided by this process and how to implement it
in real IDS.
Keywords: Distributed Denial of Service attack, Genetic Algorithm, Zombies, intruders ,intrusion
detection INTRODUCTION
The main problem with current intrusion detection systems is the high rate of false alarms triggered
off by attackers. Effective way of protecting the network against malicious attacks is the problem in
both area of research and the computer network managing professionals. Improved monitoring of
malicious attacks will require integration of multiple monitoring systems. In our current project we
are analyzing potential benefits of distributed multi sensor

Detection And Prevention System For Cloud Infrastructure
Abstract– In this era of technology when everything is available at just one click; Security is a big
issue. Hackers and intruders are getting smarter. There are various methods to protect the network
infrastructure as well as communication over the internet, for example firewalls, encryption, and
virtual private networks. Intrusion detection is a comparatively new approach to such techniques. By
using intrusion detection, we can collect and use information from acknowledged attacks and figure
out if somebody is trying to attack the network/host. In this paper, we have classified different types
of IDS. Also we have proposed a hybrid model for intrusion detection and prevention system for
cloud infrastructure, which has improved the quality of detecting the unidentified attack via
anomaly–based detection along with a module which will try to diminish the number of false alarms
which are generated by the system. Our proposed system finds random attacks in network and
prevents these attacks automatically using the mechanism.
Keywords– Intrusion detection system, Security, K–learning algorithm, Snort tool, Prevention,
Network.
I. INTRODUCTION
Attacks on the nation's computer infrastructures are becoming gradually more severe problem.
Although the problem is ubiquitous, administrations are predominantly appealing objectives as well
as they are inclined to be more willing to disclose such events than business associations. Intrusions
are the actions which violate the security

Eyewitness Memory For A Simulated Misdemeanor Crime
A review of
Eyewitness Memory for a Simulated Misdemeanor Crime: The Role of Age and Temperament in
Suggestibility
The reviewed article is about a study in which children of two different age groups, and a group of
adults were asked general–to–specific questions and misleading questions in an interview to see if
the timing of the misleading questions and temperament affected the quality of the witness's
testimony. The researchers hypothesized that the use of misleading questions by interviewer's causes
the witness to unwittingly incorporate false information into their testimony.
Method
Participants There were 90 middle–class participants, mostly Caucasian, in three different age
groups that participated in this study. The early elementary school group consisted of 16 boys and 14
girls age's six to seven. The late elementary school group consisted of 16 boys and 14 girls age's
nine to 10. The adult group consisted of six men and 24 women ranging from 17 to 29 years old, all
of which were currently attending a public Midwestern university. Three early elementary school
children, six late elementary school children, and six adults were disregarded from this study
because they did not complete the second interview. The children who participated were recruited
from university staff and from local preschools and elementary schools with parental consent. The
adults that were recruited were drawn from two undergraduate psychology classes and were given
either class or research

The Importance Of Alarm Fatigue And Its Effects On The...
Chapter Four: Evaluation
The purpose of this project was to determine if traditional education had a greater impact on the
number of false and non–actionable alarms over presenting education in an online educational
format. Evidence supports that alarm fatigue is a nursing problem that puts patients at risk for ham.
Reducing the number of nuisance alarms decreases the occurrence of alarm fatigue among
registered nurses. Evidence also supports patient harm is lessened when alarm fatigue is reduced
(Sendelbach, S., & Funk, M. 2013). Nurses are ethically obligated to reduce and remove the risk of
patient harm. Patients are at a greater risk for harm when nurse do not appropriately manage
nuisance alarms. Nurses are ethically obligated to reduce this risk of hazard to patients by following
evidence–based strategies to reduce these nuisance alarms. This chapter includes the implementation
for this project, and step by step details will be outlined. The project's results will be discussed as
well as the evaluation of the findings. Also in this chapter, evaluation of the project's design and
evaluation of the project's implementation will be examined.
The project was designed to compare false, non–actionable alarms prior to education on the
evidence–based strategies to reduce alarm fatigue, after online education and then again after
traditional face–to–face education. The project included nurses in the 14 bed cardiac intensive care
unit, within a 456 bed, not–for–profit

Clinical Alert Management Report
Develop a Clinical Alert Management Committee to facilitate management of alerts. Include key
stakeholders and contributors from clinical, technical, and information technology with interest and
experience in medication alert management. Team members include:
− Clinical Pharmacist 18
− Physicians including specialized physicians with knowledge about critical drug interaction 18
− Information Technology staff 19
− Risk Management 19
− Patient Safety
− Safe alarm management and response team to address issues with malfunctioning devices 19
Define the goals and responsibilities of the committee
− Evaluating evidence–based articles and literature in making decisions to change the severity of the
interaction by looking at specific drug–drug, ... Show more content on Helpwriting.net ...
27 o Route of administration
For example having an alert for Tacrolimus IV and Fluconazole dose exceeding 200 mg
When there is disagreement amongst clinicians about categorization, refer to additional literature to
reach a consensus
Based on recommendations from committee, implement and test the changes to the drug interactions
in the software
Implement an alert dashboard with real time data that tracks29 o How many times an alert has been
fired for a particular interaction, o How many times it's been overridden, o Who has done the
override o What department the alerts are primarily being fired in
Assign pharmacists that are responsible for medication reconciliation and making sure that there is a
current and accurate medication list.
Utilize electronic entry for comprehensive reconciliation at admission and discharge 33
Fire alerts pharmacist if medication reconciliation not completed within 24 hours (Table 7)
Alert when there are outside or new medications available for reconciliation (Table

False Alarm: Hyatt House In San Diego
False Alarm
It was all a blur. I was rapidly tying my dark gray laces on my converse as the announcement on the
speakers continued. I quickly speed walked to the nearest exit on our hotel room floor. We were all
the way up on level 12, which was bad but I guess it was better than being on level 20 under the
current circumstances. The announcement continued blaring the words, "EVERYONE MUST
EVACUATE THIS BUILDING IMMEDIATELY, YOU ARE IN IMMEDIATE DANGER
PROCCED TO THE NEAREST EXIT, DO NOT USE THE ELEVATOR."
Another relaxing day in beautiful San Diego I thought to myself as I woke up. It was the middle of
summer vacation and my family and I were currently staying at the Hyatt House in San Diego. I was
thirteen at the time. I pushed the plush ... Show more content on Helpwriting.net ...
Just as I began to get comfortable panic and fear hit me as an announcement on the hotel intercom
yelled, "EVERYONE MUST EVACUATE THIS BUILDING IMMEDIATELY, YOU ARE IN
IMMEDIATE DANGER PROCCED TO THE EXIT, DO NOT USE THE ELEVATOR." Since my
parents were still downstairs I started panicking because I had no clue what was going on. I quickly
grabbed my backpack and other essentials and began leaving the room. In addition, having to walk
down twelve flight of stairs would be another issue. Well looks like I have no choice I think to
myself as I began going down the stairs. Thoughts rush into my head about all of the things that
could possibly go wrong. As I am walking down I send a quick test to my parents and continue
jogging down the stairs. At last I step down the last step and I am out of breath. I guess I have
definitely worked off those donuts I thought to myself.
I opened up the main door and proceeded to outside the building where I saw my parents and
walked over to them. They began asking me if I was okay and if I saw anything inside the hotel. I
was telling them I was fine when a hotel employee approached us. "We are very sorry for the
inconvenience but that was a false alarm," said the employee. I was pretty angry mostly because I
walked down twelve flights of stairs for nothing. Also because of how scary this whole even

Everything You Ever Needed to Know about Gratuities but...
Introduction Research on the opinions of gratuities have been examined in the past 60 years by
scholars, researchers and law enforcement officers (). Many of these studies have dealt with the
acceptance of gratuities. Gratuities are benefits that take many forms. These are in forms of gifts,
services or cash. The quantity or the amount varies and the motivated behind the giving and
accepting of gratuities also varies. The debate of whether the acceptance of gratuities violated
ethical conduct or the perspective of law enforcement agents have not subsided. There are different
perspective of gratuities by professionals such as professor's or practitioners in the field who have
debated the positives and negatives of the acceptance of ... Show more content on Helpwriting.net ...
Overall, these multiple definitions of corruption and gratuities illustrate how critical this aspect is in
the field and the difference in opinions that have been developed.
Approval for gratuities
The acceptance of gratuities should not always be viewed as unethical. Scholars and literatures have
supported the acceptance of minor gratuities as ethical for multiple reasons. First, gratuities serve
functions beyond corruption. Gratuities are able to amend negative relationship between the
community and law enforcement. According to scholars such as Bracey, Goldstein, Reiss Jr., and
Kania, supported the view of gratuities having the capability to build and solidify good police–
community relations (Kania 2004). Secondly, if there is an over–emphasis on the acceptance of
gratuities, this might provoke a dilemma for all law enforcement officers who accepted small gifts.
If these officers feel that they are corrupted, this might lead them to other worst type of corruption.
Even though it is difficult to distinguish between minimal and over–emphasis of accepting
gratuities, it is vital to not intensely focus on gratuities. Due to

Alarm Fatigue: A Case Study
Alarm fatigue is recognized by The Joint Commission as a serious patient safety issue, with alarm
mismanagement as being the root cause of alarm fatigue (The Joint Commission, 2013). Numerous
regulatory and nursing organizations have published strategies to manage alarm fatigue, however
evidence is lacking on the best methodology of educating nurses to alarm management. Put one or
two lines of the problem the spurred this project. The aim of this study is to compare the effect of
online education methodology versus traditional education methodology on the number of false and
non–actionable alarm in a cardiac intensive care unit. Historically, the cardiac intensive care unit
continues to have an excess number of false and non–actionable alarms despite previous attempts at
raising awareness of alarm fatigue. Chapter three will describe ... Show more content on
Helpwriting.net ...
Education will consist of online modules and traditional, face–to–face, live education. Prior to
educating the nursing staff on alarm management a survey of the number of false and non–
actionable alarms will be conducted on the cardiac intensive care unit. Once the online alarm
management education has been completed by all staff on the cardiac intensive care unit, the alarms
will again be recorded. Education on appropriate alarm management will then be conducted using
the traditional methodology of live, face–to–face classroom style education. After the traditional
alarm management education has been completed, the number of alarms will once again be
recorded. The alarm data will be compiled and tabulated from three reference points, prior to online
education, after the online education, and then again after the traditional education. Furthermore, the
alarm data will be analyzed from samples taken at the same time of day for each reference

Alarm Fatigue : A Critical Patient Safety Alert
Today's healthcare community is increasingly concerned about a critical patient safety hazard known
as "alarm fatigue". Alarm fatigue occurs when caregivers are desensitized by the frequent sounding
of competing alarms from medical equipment, and other sources in a healthcare setting. Clinical
alarms can be unintentionally overlooked as background noise, and drown out actionable warning
signs that require vital clinical interventions. These alarm safety issues have led to unfavorable and,
at times, even fatal patient outcomes.
Alarm fatigue is a complex and multi–faceted issue that healthcare organizations continue to
struggle with on a daily basis. Although there is a wealth of information regarding recommended
clinical alarm management ... Show more content on Helpwriting.net ...
Multidisciplinary collaboration and continuous quality improvement among key stakeholders in the
healthcare community is essential to effectively improve alarm management strategies that focus on
optimizing patient safety and enhancing clinical care.
With the proliferation of technology in the today's healthcare environment, the healthcare
community is increasingly concerned about the patient safety risks associated to clinical alarm
hazards. In 2012, 2013, and 2014, the Emergency Care Research Institute (ECRI) identified clinical
alarm hazards as a high priority potential danger area in hospitals and health systems (ECRI, 2014).
The Joint Commission, the American Association of Critical–Care Nurses (AACN), the Food and
Drug Administration (FDA), ECRI, and the Association for the Advancement of Medical
Instrumentation (AAMI) have all identified the need to address alarm management and alarm
fatigue as a priority patient safety concern (Horkan, 2014). In response to these concerns, federal
regulatory mandates are increasingly coupled with recommended alarm management practices and
protocols. Despite these focused efforts, alarm fatigue and alarm management continue to be priority
national patient safety concerns.
To understand more about the problems associated with alarm fatigue, in 2012 Assistant Nursing
Director Maria Cvach, MS, RN, CCRN, at The Johns Hopkins Hospital in Baltimore, MD,
published research studies in Biomedical Instrumentation & Technology.

Spectrum Scarcity Problem Of Wide Band
Abstract– Spectrum scarcity problems happen due to the spread of various wireless devices and
technologies engaging static frequency access and to cope up with this demand, Cognitive Radio is a
solution of enormous outlook. This article discusses spectrum scarcity problem in wide band. To
solve high sampling rate problems in wide band, compressive sensing is done here.A wide band
signal is passed through fading channels and then it is estimated using ℓ1 magic technique. Then
receiver–operating characteristic curve of the evaluated signal is estimated.
Keywords: Fading channel,ℓ1 magic technique, receiver–operating characteristic curve.
I.INTRODUCTION The expanding demand for wireless affinity and current congestion of
unlicensed spectra has pushed the authoritative agencies to be more hopeful in providing new paths
to adopt spectra [1]. The reason behind this is the increasing interest of consumers in wireless
services which in turn is driving the evolution of wireless networks toward high–speed data
networks [2]. The traditional path to spectrum management is very immutable because each operator
is acknowledged an exclusive license to operate in a certain frequency band. Though, with most of
the useful radio spectrum already designated, it is becoming enormously tough to find unfilled
bands to either utilize new services or strengthen existing ones [3].
Main theme of the complete operation of Cognitive Radio (CR) systems

Nursing Case Study Alarm Management
Background
A sentinel alarm event occurred at several hospitals within the AW Network, which prompted the
Pennsylvania Department of Health to conduct a Center for Medicare Services level investigation.
This type of investigation requires an action plan with a measure of correction. Parallel with the
alarm events, the Joint Commission had created the National Patient Safety Goal 06.01.01, also
known as goal six, to reduce harm associated with clinical alarms (The Joint Commission, 2014).
The potential patient risks for an adverse event from alarm mismanagement are experienced around
the world, and while the particulars of each event varies; research suggests that by reducing
nuisance alarms, the chance for an adverse event diminishes (Gorges, ... Show more content on
Helpwriting.net ...
Education of this in the organization about the alarm system management will also be required in
January, 2016. Person responsible:
Patient Safety
Clinical Engineering
Nursing/ Leadership
Patient Safety
Clinical Engineering
Nursing Leadership When to be done:
Begin in 2014
Begin in 2016 Where to be done:
All A Network facilities
All X Network facilities
Alarm Assessment Teams Leaders:
Cardiac
Critical Care
Maternal Child
Perioperative PS
Nursing
Clinical Engineering To begin Feb.
2015 Throughout nursing departments and care/service areas
Plan
List the tasks needed to set up this test of change Person responsible When to be done Where to be

done
1.Determine the Group membership belonging to each team
2. Establish meeting times
3. Develop a policy and process
4. Define steps
Each group will make alarm assessment and determine with the multidisciplinary team the level of
importance of each alarm.
The alarm settings will be determined by the teams based on level of severity.
Visual assessment
Auditory assessment measured in decibels
Response assessment Patient Safety
CNO
Clinical Eng.
Nursing Clinical Eng. Clinical Eng.

Quality Measure : Fall Prevention
Quality Measure: Fall Prevention
Jacqueline Simons
Health Policy, Quality, Political
June 27, 2016
Quality Measure and Its Intent Quality improvement is referred to as "the use of data to monitor the
outcomes for care processes and use improvement methods to design and test changes to
continuously improve the quality and safety of health care" (Sherwood & Barnsteiner, 2012). Data is
used as the reflection of quality care that is provided by nurses and presents whether or not
improvement is needed. In order for nurses to be mindful of the care that they give, they must be
taught a systematic process of defining problems, identifying possible causes of those problems, and
methods for trying out new solutions to prevent those problems (Sherwood & Barnsteiner, 2012).
Currently, quality improvement measures are being utilized throughout hospitals to reduce the risk
of patient falls and fall injuries. As the United States population is advancing in age, the amount of
patient falls and medical costs are estimated to increase. Approximately 700,000 patients fall per
year in the hospital, which one–third of those falls could have been prevented (AHRQ, 2012).
Prolonged hospital stays related to fall injuries is very costly. In 2013, a total of $34 billion dollars
was paid due to falls by patients and insurance companies (CDC, 2015). Examples of injuries that
can occur as a result of falls are fractures, lacerations, or internal bleeding (AHRQ, 2012). Studies
also show

Alarm Fatigue
Abstract
Clinical alarm systems in acute and critical care health care settings are an assistive way to maintain
communication between the client and the nurse. Awareness and comprehension of health devices is
crucial to provide nurses with appropriate strategies for critical or non critical interventions that can
lead to sentinel events. The ECRI, a nonprofit institute, has identified alarm hazards as the "Top Ten
Health Technology Hazards" for 2014. (cite) In 2013 The Joint Commission published a Sentinel
Event Alert proposing a National Safety Goal to focus on alarm safety (cite). This topic is pertinent
information to be recognized and set as an achievable action in improving patient safety.
Carol Lukasewicz is a health care inspector in Seattle, Washington. She worked as a patient safety
specialist at the VA Puget Sound Health Care System in Seattle, Washington.
Elizabeth Andersson Mattox is an adult acute care nurse practitioner and clinical program manager
in the Department of Pulmonary and Critical Care Medicine at the VA Puget Sound Health Care
System in Seattle, Washington
There are an abundance of contributing factors and to understand these, nurses should be initially
educated on the ... Show more content on Helpwriting.net ...
The definition of Alarm Fatigue is a situation where people become desensitized to alarms in
response to excessive exposure (merriam– webster dictionary). Alarm fatigue also causes attention
spans to be lowered which affects Nurses readiness for an emergency on their shift. Alarms can be
overwhelming and all alarm alerts are designed differently. In an environment of constant urgency
Nurses have even been described as ignoring the alarms or being negligent. There are also many
different alarm terms, from false alarms and high sensitivity alarms to nuisance alarms. With so
many alarm–related terms it is relevant to ensure proper understanding of these the terms to reduce
risky

Literature Review Of Alarm Fatigue

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