24-Hour Inpatient Pulse Oximetry Monitoring Reduces Rescue Events and Intensive Care Unit Transfers | AHRQ Innovations Exchange

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Andreas H. Taenzer, MD, FAAP 

24-Hour Inpatient Pulse Oximetry Monitoring Reduces Rescue Events and Intensive Care Unit Transfers | AHRQ Innovations Exchange



Alarm Fatigue in Hospital Settings

This issue includes

Innovations:

• 24-Hour Inpatient Pulse Oximetry Monitoring Reduces Rescue Events

Summary Most inpatient units at Dartmouth-Hitchcock Medical Center use round-the-clock monitoring via a pulse oximetry system that recognizes the early signs of deterioration in patients. Tracking blood oxygen saturation levels and heart rate, the system automatically alerts the nurse via pager when preset thresholds are violated. To reduce "alarm fatigue"—the tendency for medical staff to become desensitized to frequent alarms—preset thresholds are set to identify situations that truly require intervention based on patient need, and the pager notification is activated only after the threshold has been met for more than 30 seconds (to avoid false alarms triggered by patient movements or actions). All nurses receive training on proper use of the system. The program has significantly reduced rescue events and transfers to the intensive care unit without causing adverse events and has been well accepted by patients. Evidence Rating (What is this?) Moderate: The evidence consists primarily of pre- and post-implementation comparisons of rescue events and intensive care unit transfers on an orthopedic unit that implemented the program, along with comparisons with two other surgical units that had not implemented it. Developing Organizations Dartmouth-Hitchcock Medical Center Date First Implemented 2007