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The influence of patient characteristics on the alarm rate in intensive care units : a retrospective cohort study

  • Intensive care units (ICU) are often overflooded with alarms from monitoring devices which constitutes a hazard to both staff and patients. To date, the suggested solutions to excessive monitoring alarms have remained on a research level. We aimed to identify patient characteristics that affect the ICU alarm rate with the goal of proposing a straightforward solution that can easily be implemented in ICUs. Alarm logs from eight adult ICUs of a tertiary care university-hospital in Berlin, Germany were retrospectively collected between September 2019 and March 2021. Adult patients admitted to the ICU with at least 24 h of continuous alarm logs were included in the study. The sum of alarms per patient per day was calculated. The median was 119. A total of 26,890 observations from 3205 patients were included. 23 variables were extracted from patients' electronic health records (EHR) and a multivariable logistic regression was performed to evaluate the association of patient characteristics and alarm rates. Invasive blood pressure monitoring (adjusted odds ratio (aOR) 4.68, 95%CI 4.15–5.29, p < 0.001), invasive mechanical ventilation (aOR 1.24, 95%CI 1.16–1.32, p < 0.001), heart failure (aOR 1.26, 95%CI 1.19–1.35, p < 0.001), chronic renal failure (aOR 1.18, 95%CI 1.10–1.27, p < 0.001), hypertension (aOR 1.19, 95%CI 1.13–1.26, p < 0.001), high RASS (aOR 1.22, 95%CI 1.18–1.25, p < 0.001) and scheduled surgical admission (aOR 1.22, 95%CI 1.13–1.32, p < 0.001) were significantly associated with a high alarm rate. Our study suggests that patient-specific alarm management should be integrated in the clinical routine of ICUs. To reduce the overall alarm load, particular attention regarding alarm management should be paid to patients with invasive blood pressure monitoring, invasive mechanical ventilation, heart failure, chronic renal failure, hypertension, high RASS or scheduled surgical admission since they are more likely to have a high contribution to noise pollution, alarm fatigue and hence compromised patient safety in ICUs.

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Metadaten
Author:Zeena-Carola Sinno, Denys Shay, Jochen Kruppa-ScheetzORCiD, Sophie Anne Ines KlopfensteinORCiD, Niklas GiesaORCiD, Anne Rike FlintORCiD, Patrick Herren, Franziska ScheibeORCiD, Claudia SpiesORCiD, Carl HinrichsORCiD, Axel WinterORCiD, Felix BalzerORCiD, Akira-Sebastian PoncetteORCiD
Title (English):The influence of patient characteristics on the alarm rate in intensive care units : a retrospective cohort study
URN:urn:nbn:de:bsz:959-opus-58651
DOI:https://doi.org/10.1038/s41598-022-26261-4
ISSN:2045-2322
Parent Title (English):Scientific Reports
Document Type:Article
Language:English
Year of Completion:2022
Release Date:2024/04/18
Issue:12
Article Number:21801
Page Number:7
Faculties:Fakultät AuL
DDC classes:600 Technik, Medizin, angewandte Wissenschaften / 610 Medizin, Gesundheit
Review Status:Veröffentlichte Fassung/Verlagsversion
Licence (German):License LogoCreative Commons - CC BY - Namensnennung 4.0 International