Multicentric study of monitoring alarms in the adult intensive care unit (ICU): a descriptive analysis.
OBJECTIVE
To assess the relevance of current monitoring alarms as a warning system in the adult ICU.


METHODS
Prospective, observational study.


METHODS
Two university hospital, and three general hospital, ICUs.


METHODS
Hundred thirty-one patients, ventilated at admission, from different shifts (morning, evening, night) combined with different stages of stay, early (0-3 days), intermediate (4-6 days) and late (> 6 days).


METHODS
Experienced nurses were asked to record the patient's characteristics and, for each alarm event, the reason, type and consequence.


RESULTS
The mean age of the patients included was 59.8 +/- 16.4 and SAPS1 was 15.9 +/- 7.4. We recorded 1971 h of care. The shift distribution was 78 mornings, 85 evenings and 83 nights; the stage distribution was 88 early, 78 intermediate and 80 late. There were 3188 alarms, an average of one alarm every 37 min: 23.7% were due to staff manipulation, 17.5% to technical problems and 58.8% to the patients. Alarms originated from ventilators (37.8%), cardiovascular monitors (32.7%), pulse oximeters (14.9%) and capnography (13.5%). Of the alarms, 25.8% had a consequence such as sensor repositioning, suction, modification of the therapy (drug or ventilation). Only 5.9% of the alarms led to a physician's being called. The positive predictive value of an alarm was 27% and its negative predictive value was 99%. The sensitivity was 97% and the specificity 58%.


CONCLUSIONS
The study confirms that the level of monitoring in ICUs generates a great number of false-positive alarms.
Chambrin
M C
MC
UPRES 2689, University of Lille 2, France. chambrin@lille.inserm.fr
Ravaux
P
P
Calvelo-Aros
D
D
Jaborska
A
A
Chopin
C
C
Boniface
B
B
D000328:Adult; D019296:Capnography; D004562:Electrocardiography; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005189:False Positive Reactions; D005260:Female; D005602:France; D006769:Hospitals, General; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units / Q000592:standards* / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D010092:Oximetry; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012121:Respiration, Artificial; D017751:Safety Management / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index