Assignment: Isolated Abnormalities

Assignment: Isolated Abnormalities

Our findings, using the voices of practicing staff nurses, confirm there is much more to be done to improve the nursing work environment relative to use of medical devices with clinical alarms. A work environment characterized by vi- sual and auditory overstimulation of mostly ir- relevant nonactionable data is not conducive to patient safety. Nursing energy trying to tune out noise and flashing of meaningless information, to find data of value that requires a response, could be better spent on patient-specific clinical care. In the context of a busy specialty unit, these conditions may increase risk of preventable pa- tient harm. Development and testing of mater- nal and fetal physiologic alarm parameters that labor nurses would find helpful and that avoid false notifications is needed.

Limitations The study has limitations. Although themes gen- erated from the focus groups are consistent with findings of others about alarms in the ICU setting,1,4,6,7,9,17,18 participants were from 2 hos- pitals and cannot be assumed to represent per- ceptions and experiences of nurses in other fa- cilities with different characteristics and patient populations. Participants worked in units that were relatively new and perhaps had more so- phisticated monitoring technology than the aver- age US hospital. The sample size and the number of groups were relatively small. However, other studies have demonstrated that themes are gen- erated quickly in focus groups, and 3 groups are enough to generate the most prevalent themes.19

This along with the consistency of our findings with other ICU setting20 findings suggests some transferability.

CONCLUSIONS Clinical alerts and alarms continue to be a problem, even in new hospitals with sophisti- cated technology. Newer systems that allow for

trended data rather than isolated abnormali- ties, and delays in reporting data that were fol- lowed by a return to expected parameters, were not reported being used.

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