Distractors in Clinical Practice Discussion Paper

Distractors in care provision have been known to affect the ability of staff to promptly and effectively respond to changes in patient condition. Alarm fatigue is a distractor that can result in desensitization, disruption and anxiety in both nurses and patients (Lewandowska et al, 2020). Desensitization in particular has been identified as a consequence of alarm fatigue that contributes to poor patient outcomes through delayed response and missed events especially in critical care settings.  Distractors in Clinical Practice Discussion Paper

Alarm fatigue has been attributed to numerous alerts that nursing staff have to respond to. For instance, take the case of an elderly hypertensive patient with poor cardiac rhythms admitted for chest pain. Telemetry systems are used transmit ECG data to monitor watchers tasked with identifying alarms and alerting nurses. As it happens, most monitoring systems are set to high sensitivity by manufacturers (Kane-Gill et al, 2017) and the nurse in charge is bombarded by alerts concerning the elderly patient. After checking on the patient for, say, 40 times and finding them in stable condition, the nurse anticipates further alerts to be false and of low urgency, and thus delays response. However, one of these alarms happens not to be false, the patient suffers heart failure and dies. The nurse’s delayed response does not help arrest the situation in any way.

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Apart from alarm fatigue, frequent interruptions and divided attention from use of cell phones can cause such preventable adverse outcomes. By virtue of being preventable, the healthcare workers involved can be sued for professional malpractice and the healthcare facility becomes vulnerable to legal action under vicarious liability. In the ethical sense, the poor outcomes resulting from distractions do not lend to the tenet of patient safety. It is thus prudent for nurses to understand why an alert is occurring and resolve it to reduce the number of alarms and likelihood of alarm fatigue. It is also essential for healthcare facilities to develop policies and standards to raise awareness on distractors and implement interventions to ensure patient safety (Kane-Gill et al, 2017). Distractors in Clinical Practice Discussion Paper

References

Kane-Gill, S. L., O’Connor, M. F., Rothschild, J. M., Selby, N. M., McLean, B., Bonafide, C. P., Cvach,

M.M., Hu, X., Konkani, A., Pelter, M.M., & Winters, B. D. (2017). Technologic distractions (part 1): summary of approaches to manage alert quantity with intent to reduce alert fatigue and suggestions for alert fatigue metrics. Critical care medicine, 45(9), 1481-1488.

Lewandowska, K., Weisbrot, M., Cieloszyk, A., Mędrzycka-Dąbrowska, W., Krupa, S., & Ozga, D. (2020).

Impact of alarm fatigue on the work of nurses in an intensive care Environment—A systematic review. International journal of environmental research and public Distractors in Clinical Practice Discussion Paper