Study: Data-Driven Physiologic Alarm Parameters Can Help Reduce Alarm Fatigue | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Study: Data-Driven Physiologic Alarm Parameters Can Help Reduce Alarm Fatigue

July 22, 2016
by Heather Landi
| Reprints
Click To View Gallery

Alarm fatigue from clinical decision support systems is a significant hazard in hospitals. Excessive alarm activations can become so commonplace that physicians miss alarms, and studies have shown that frequent disruptive alarms can impact patients’ sleep and recovery.

According to a study of hospitalized children at Lucile Packard Children’s Hospital Stanford in  Palo Alto, California, researchers found that tailoring physiologic bedside monitor alarm limits using data-driven heart rate and respiratory rate parameters may reduce the frequency of false alarms, thereby mitigating alarm fatigue. The study was published in the Journal of Hospital Medicine.

“Improper alarm settings are one of four major contributing factors to reported alarm-related events, and data-driven HR and RR parameters provide a means by which to address the Joint Commission Sentinel Event Alert and National Patient Safety Goal regarding alarm management safety for hospitalized pediatric patients. Our results suggest that this evidence-based approach may reduce that frequency of false alarms (thereby mitigating alarm fatigue), and should be studied prospectively for implementation in the clinical setting,” the study authors wrote.

The researchers aimed to create and validate heart rate and respiratory rate percentiles for hospitalized children, and analyze the safety of replacing current vital sign reference ranges with proposed data-driven, age-stratified 5th and 95th percentile values.

According to the study, the researchers performed a cross-sectional study of children less than 18 years of age hospitalized on general medical and surgical units at Lucile Packard Children’s Hospital Stanford, a 311-bed quaternary-care academic hospital with a full complement of pediatric medical and surgical subspecialties and transplant programs. During the study period, the hospital used the Cerner EHR Millennium technology platform and Philips IntelliVue bedside monitors.

In the retrospective cross-sectional study, nurse-charted heart rate and respiratory rate data from a training set of 7,202 hospitalized children were used to develop percentile tables. The researchers compared 5th and 95th percentile values with currently accepted Institutes of Health-recommended reference ranges in a validation set of 2,287 patients. And, researchers analyzed 148 rapid response team and cardiorespiratory arrest events over a year, using heart rate and respiratory rate values in the 12 hours prior to the event, to determine the proportion of patients with out-of- range vitals based upon reference versus data-driven limits.

The study findings indicate there were 55.6 percent fewer out-of-range measurements using data-driven vital sign limits.

“Overall, 144/148 rapid response team and cardiorespiratory arrest event patients had out-of-range heart rate or respiratory rate values preceding the event using current limits, and 138/ 148 were abnormal using data-driven limits. Chart review of rapid response team and cardiorespiratory arrest event patients with abnormal heart rate and respiratory rate per current limits considered normal by data-driven limits revealed that clinical status change was identified by other vital sign abnormalities or clinical context, the study authors wrote.

The study authors concluded, “A large proportion of heart rate and respiratory rate values for hospitalized children at our institution are out of range according to current vital sign reference ranges. Our new data-driven alarm parameters for hospitalized children provide a potentially safe means by which to modify physiologic bedside monitor alarm limits, a first step toward customization of alarm limit settings in an effort to mitigate alarm fatigue.”

Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More



NIH Releases First Dataset from Adolescent Brain Development Study

The National Institutes of Health (NIH) announced the release of the first dataset from the Adolescent Brain Cognitive Development (ABCD) study, which will enable scientists to conduct research on the many factors that influence brain, cognitive, social, and emotional development.

Boston Children's Accelerates Data-Driven Approach to Clinical Research

In an effort to bring a more data-driven approach to clinical research, Boston Children’s Hospital has joined the TriNetX global health research network.

Paper Records, Films Most Common Type of Healthcare Data Breach, Study Finds

Despite the high level of hospital adoption of electronic health records and federal incentives to do so, paper and films were the most frequent location of breached data in hospitals, according to a recent study.

AHA Appoints Senior Advisor for Cybersecurity and Risk

The American Hospital Association (AHA) has announced that John Riggi has joined the association as senior advisor for cybersecurity and risk.

Report: Healthcare Accounted for 45% of All Ransomware Attacks in 2017

Healthcare fell victim to more ransomware attacks than any other industry in 2017, according to a new report from global cybersecurity insurance company Beazley.

Study: Use of EHRs Does Not Reduce Administrative Costs

A recent study by Duke University and Harvard Business School researchers found that costs for processing a single bill ranged from $20 for a primary care visit to $215 for an inpatient surgical procedure, or up to 25 percent of revenue.