Impact of a Data-driven Monitor Alarm Reduction Strategy Implemented in Safety Huddles

Hospitalization Clinical Trial

Official title:

Impact of a Data-driven Monitor Alarm Reduction Strategy Implemented in Safety Huddles

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02458872
• Other study ID #: 15-011896
• Status: Completed
• Phase: N/A
• First received: May 28, 2015
• Last updated: June 1, 2017
• Start date: July 2015
• Est. completion date: May 2016

Study information

• Verified date: June 2017
• Source: Children's Hospital of Philadelphia
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a pragmatic, paired, cluster-randomized controlled trial evaluating the impact of a safety huddle-based intervention on physiologic monitor alarm rates on pediatric inpatient units.

Description:

Hospital physiologic monitors can alert clinicians to early signs of physiologic deterioration, and thus have great potential to be life-saving. However, monitors generate frequent alarms, most of which are non-actionable.

When clinicians become overburdened with alarms, they begin to exhibit alarm fatigue:

responding more slowly to alarms or ignoring alarms entirely. In this protocol the investigators outline the methods they will use to evaluate the impact of a safety huddle-based intervention on physiologic monitor alarm rates using a pragmatic, paired, cluster-randomized controlled trial with the intervention delivered at the unit level. This work is considered quality improvement research, and some of the approaches described in this protocol are from the field of quality improvement.

Currently, at most hospitals data like this on the numbers of alarms that patients generate are only available to researchers with the software tools needed to interrogate and record data from the monitor network. The goal of this proposal is to bring this data to the safety huddles occurring daily on inpatient units in an accessible format to help teams make informed decisions about monitoring and minimize the potential of harm from alarm fatigue.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 77280
• Est. completion date: May 2016
• Est. primary completion date: May 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion criteria: Any nurse, physician, nurse practitioner, or physician assistant caring for a patient whose alarms are discussed in a safety huddle on an intervention unit.

Exclusion criteria: none

Related Conditions & MeSH terms

• Hospitalization

Intervention

Behavioral:
• safety huddle alarm intervention
The intervention consists of a monitor alarm dashboard that displays the numbers and types of alarms for each patient, and an accompanying checklist to guide data-driven discussion of 2-4 patients with high alarm rates.

Locations

Country	Name	City	State
United States	Children's Hospital of Philadelphia	Philadelphia	Pennsylvania

Sponsors (2)

Lead Sponsor	Collaborator
Children's Hospital of Philadelphia	Academic Pediatric Association

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change from baseline in the unit-wide rate of alarms per patient-day at 44 weeks		Baseline and 44 weeks
Secondary	Pre-post huddle patient-level difference in differences of alarm rates	The difference in the rate of alarms in individual patients in the 24 hours after discussion in a huddle compared with themselves in the 24 hours before the huddle, patients on the same unit as the huddle but whose alarms are not discussed, and patients on units without the alarm huddle intervention.	The 24 hours before a safety huddle opportunity versus the 24 hours before a safety huddle opportunity
Secondary	Implementation outcomes	Proportion of huddles in post-implementation data collection period that included discussion of at least 1 patient's alarms, proportion of patients in whom a change in monitor delay time was recommended who had delay time changed in a direction consistent with the recommendations within 4 hours	Within 4 hours after the huddle intervention occurred