Epidemiology of patient monitoring alarms in the neonatal intensive care unit
Name
nihms945044.pdf
Description
Accepted version
Size
411.32 KB
Format
Adobe PDF
Checksum (MD5)
a1e51fd170fcad58e94b64b559bdddd2
Author(s)
Matsushima, Minoru
Timpson, Wendy
Young, Susan
Miedema, David
Gupta, Munish
Li, Taibo,M. Eng.Massachusetts Institute of Technology.
Date Issued
May 2018
Journal
Journal of Perinatology
Publisher
Springer Nature
Citation
Li, Taibo, et al. “Epidemiology of Patient Monitoring Alarms in the Neonatal Intensive Care Unit.” Journal of Perinatology, 38, 8 (August 2018): 1030–38.
Version
Author's final manuscript
Abstract
Objective: To characterize the rate of monitoring alarms by alarm priority, signal type, and developmental age in a Level-IIIB Neonatal Intensive Care Unit (NICU) population. Study design: Retrospective analysis of 2,294,687 alarm messages from Philips monitors in a convenience sample of 917 NICU patients, covering 12,001 patient-days. We stratified alarm rates by alarm priority, signal type, postmenstrual age (PMA) and birth weight (BW), and reviewed and adjudicated over 21,000 critical alarms. Results: Of all alarms, 3.6% were critical alarms, 55.0% were advisory alarms, and 41.4% were device alerts. Over 60% of alarms related to oxygenation monitoring. The average alarm rate (±SEM) was 177.1 ± 4.9 [median: 135.9; IQR: 89.2–213.3] alarms/patient-day; the medians varied significantly with PMA and BW (p < 0.001) in U-shaped patterns, with higher rates at lower and higher PMA and BW. Based on waveform reviews, over 99% of critical arrhythmia alarms were deemed technically false. Conclusions: The alarm burden in this NICU population is very significant; the average alarm rate significantly underrepresents alarm rates at low and high PMA and BW. Virtually all critical arrhythmia alarms were artifactual.
MIT Department
Massachusetts Institute of Technology. Institute for Medical Engineering & Science
Terms of Use
Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use.
Persistent DSpace Link
DOI of Published Version
https://doi.org/10.1038/S41372-018-0095-X
