Nurses Can Become Desensitized To Hospital Sounds

Michele Norris speaks with Boston Globe reporter Liz Kowalczyk about her investigative series on how hospital staff can tune out or not react with urgency to patient alarms.

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MICHELE NORRIS, host:

When you visit a hospital, it's not uncommon to hear the sounds associated with medical technology. Sounds like these...

(Soundbite of beeping)

NORRIS: High-pitched beeps admitted by all kinds of monitors. Those persistent beeps can help save lives by alerting medical personnel that a patient is in trouble, but they can also turn out to be false alarms.

Now, an investigation by the Boston Globe explores a dangerous phenomenon called alarm fatigue, when nurses are so desensitized to the beeps that they fail to respond.

Reporter Liz Kowalczyk wrote the series. She says the sounds from patient monitors are alarmingly common.

Ms. LIZ KOWALCZYK (Reporter, Boston Globe): This one small unit at Johns Hopkins, a 15-bed unit, documented 942 alarms a day. That's about one alarm every 90 seconds.

NORRIS: And to help us understand when medical personnel don't respond to one of these alarms, perhaps you could quickly walk us through one of the cases.

Ms. KOWALCZYK: One of the cases that I wrote about involved an elderly woman at UMass Memorial Medical Center in Worcester, Massachusetts. She was in the hospital to get a cardiac catheterization. Her monitor sounded an alarm for about an hour, indicating a weak battery. And then for about 15 minutes, indicating a battery that was about to die. And no one responded to that alarm and she did have a heart attack. And because the alarm - the monitor wasn't working, there was no alarm to alert staff to her heart attack.

NORRIS: In that case, or in the many others that you investigated, how do you know that a swift response really would've saved the patient's life?

Ms. KOWALCZYK: You really don't know. You know, doctors in this case had told the family that they didn't believe a swift response would've saved her. But on the other hand, she was someone who doctors predicted would leave the hospital.

NORRIS: Do the devices themselves have problems or flaws that contribute to alarm fatigue?

Ms. KOWALCZYK: Well, I think you would hear a lot of nurses and doctors saying that they do. The big problem for nurses is that most - the vast majority of these alarms are false alarms. The machines are so sensitive, that they alarm when a patient coughs, they alarm when a patient turns over. And that contributes to alarm fatigue.

NORRIS: What has been the reaction from medical personnel, particularly the nursing community?

Ms. KOWALCZYK: You know, I was very worried about the reaction from the nursing community because I didn't want the stories to feel like we were blaming them for something. And, actually, I was pleasantly surprised that they have acknowledged and confirmed that this is a big problem that they face. And they feel like it's very valuable to get a discussion of this out in the open.

NORRIS: So, what can be done about this? How are hospitals responding?

Ms. KOWALCZYK: Well, I think there are some short-term solutions. Hospitals are trying, you know, one is to hire nurses or technicians whose sole job is just to monitor the monitors. Another solution hospitals are looking at is trying to reduce the number of people on monitors. There are a lot of patients on cardiac monitors who probably don't need to be on cardiac monitors.

But, you know, there has to be systemic longer term solutions that are reached in cooperation with companies in terms of how these monitors work and trying to reduce the number of false alarms that they produce.

NORRIS: Liz Kowalczyk, thank you very much for speaking with us

Ms. KOWALCZYK: Thank you very much.

NORRIS: We've been speaking with Liz Kowalczyk. She wrote a series for the Boston Globe on a condition known as alarm fatigue.

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