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It's MORNING EDITION from NPR News. I'm Renee Montagne.


And I'm Steve Inskeep.

Today in Your Health, it is sometimes possible to try too hard. And we have two stories in our occasional series Less Is More. Sometimes, less aggressive care or less technology can be better for you. For example, a simple alternative to surgery can help kids with club feet.

But first, NPR's Richard Knox reports on a growing problem for hospitals: alarm fatigue.

RICHARD KNOX, BYLINE: Go into most any hospital these days and you'll hear something like this.


KNOX: To most people it sounds like medical Muzak. But to doctors and nurses, those constant beeps are coded messages.


JAMES PIEPENBRINK: That's a crisis.


PIEPENBRINK: That's a warning.


PIEPENBRINK: That's an advisory.


PIEPENBRINK: That's a crisis.

KNOX: James Piepenbrink is chief clinical engineer at Boston Medical Center. We're on 7-North, a cardiac care unit with 24 sick patients wired up to various monitors.

PIEPENBRINK: And each of them may have multiple alarms occurring.

KNOX: Piepenbrink and his colleagues added them up. 7-North was averaging close to 12,000 alarms a day.

Deborah Whalen, a nurse-manager here, says it was producing alarm fatigue.

DEBORAH WHALEN: Alarm fatigue is when there are so many noises on the unit that it actually de-sensitizes the staff, so the staff no longer hear them. If you have multiple, multiple alarms going off with varying frequencies, you just don't hear them.

KNOX: That obviously can be dangerous. Patients can die when an important alarm is missed or an electrode gets unstuck or a monitor's battery goes dead. Boston Medical Center hasn't recorded any patient deaths due to alarm failure.

WHALEN: We were lucky.

KNOX: But national data bases have recorded hundreds of alarm-related deaths in recent years. And the known alarm deaths are just the tip of an iceberg, says Dr. Ana McKee, chief medical officer of a quality control group called The Joint Commission.

DR. ANA MCKEE: It is pervasive in almost any accident that occurs in a hospital. If you look carefully, you will most likely find that there was an alarm as a contributing factor.

KNOX: That's why The Joint Commission has put alarm fatigue at the top of its current list of problems that hospitals are expected to tackle. McKee says technology has gotten out of control.

MCKEE: We have devices that beep when they are working normally. We have devices that beep when they're not working.

KNOX: Boston Medical Center is one of the few hospitals that apparently have conquered alarm fatigue. Its analysis show that the vast majority of alarms are unnecessary. They can simply be switched off. Other low-level alarms were upgraded to crisis mode. And Deborah Whalen says nurses were given authority to change alarm settings to account for individual patients' differences.

WHALEN: Once that happened, many, many, many, many alarms disappeared. And instead of 90,000 alarms a week, we dropped to 10,000 alarms a week.

KNOX: She says it's a clear case of less is more.

WHALEN: I think less is better. If you have more and more and more data, more and more alarms, more and more technology bad data in, bad decisions made.

UNIDENTIFIED WOMAN: Doreen you have a call on line one. Doreen, line one.

KNOX: On 7-North, and throughout Boston Medical Center, you can easily hear the difference.


KNOX: That was several seconds without an alarm. Nurse Amanda Gerity says when a crisis alarm does sound, the staff can easily hear and respond.

AMANDA GERITY: It's a lot more manageable.

KNOX: How's your life changed?

GERITY: It's a lot more pleasant being at work. I don't go home and I don't sleep and hear alarms in my dreams anymore.


INSKEEP: The hospital says patients like it better too. For one thing, when they press the nurse-call button, the nurse is more likely to hear it.

Richard Knox, NPR News, Boston.

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