New AHRQ Patient Safety Primer on Alert Fatigue Asserts Increase in Electronic Alarms Might Harm Patients

The rapidly increasing computerization of health care has produced benefits for clinicians and patients, yet the integration of technology into medicine has been anything but smooth, according to a new primer on alert fatigue posted on AHRQ’s Patient Safety Network. For instance, computerized provider order entry systems, smart intravenous infusion pumps and cardiac monitoring devices provide auditory or visual warnings to clinicians to prevent or act on unsafe situations. In the highly computerized clinical environment, clinicians may experience dozens of warnings and alerts a day. The term “alert fatigue” describes how clinicians become desensitized to safety alerts, and as a result, ignore or fail to respond appropriately to such warnings. The phenomenon occurs because of the number of alerts. Most alerts are clinically inconsequential, and in most cases clinicians should ignore them. However, clinicians also ignore both clinically meaningless alarms and critical alerts that warn of impending serious patient harm. In essence, the primer stated, the proliferation of alerts intended to improve safety paradoxically increases the chance that patients will be harmed.