Epidemiology of patient monitoring alarms in the neonatal intensive care unit
Author(s)Matsushima, Minoru; Li, Taibo; Timpson, Wendy; Young, Susan; Miedema, David; Gupta, Munish; ... Show more Show less
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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.
DepartmentMassachusetts Institute of Technology. Institute for Medical Engineering and Science
Journal of Perinatology
Li, Taibo, et al. “Epidemiology of Patient Monitoring Alarms in the Neonatal Intensive Care Unit.” Journal of Perinatology, 38, 8 (August 2018): 1030–38.
Author's final manuscript