title: Whats that noise? Bedside monitoring in the Emergency Department.
abstract: OBJECTIVE
  To determine the frequency, duration and type of audible monitor alarms in an ED, utilising the standard manufacturer's classification.
  
  
  METHODS
  The audible monitor alarms and the timing of any intervention related to the patient monitoring was observed and recorded.
  
  
  RESULTS
  110 Patients admitted to the Majors area or Resuscitation Room were observed for a total of 93 hours. One monitor was observed at a time. Alarm noise was generated 29% of the observation time. Overall, 429 alarms lasting 21 hours 27 minutes were judged to be positive and 143 alarms lasting 5 hours 47 minutes, negative. 74% of Resuscitation Room and 47% of Majors alarms were silenced or paused. Alarm limit parameters were only adjusted after 5% of alarms in Resuscitation Room and 6% of alarms in Majors.
  
  
  CONCLUSIONS
  Whilst high level monitoring is desired from a patient safety perspective, it contributes to a significant ambient noise level, which is recognised by all who pass through an ED, and can be detrimental to patients, relatives and staff. We have demonstrated that there is a high probability of near-continuous alarm noise from patient monitoring in a 10-bedded Majors area. We make suggestions for methods of noise reduction and intend to implement some of these within our own ED.
authors.affiliation: Emergency Department, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, United Kingdom. Electronic address: rob.way@ouh.nhs.uk.
authors.forename: Rob B
authors.initials: RB
authors.lastname: Way
authors.affiliation: Emergency Department, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, United Kingdom.
authors.forename: Sally A
authors.initials: SA
authors.lastname: Beer
authors.affiliation: Emergency Department, Wexham Park Hospital, Slough, Bucks SL2 4HL, United Kingdom.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Wilson
mesh_terms: D056902:Clinical Alarms / Q000009:adverse effects*; D004636:Emergency Service, Hospital; D006801:Humans; D009622:Noise / Q000009:adverse effects*; D019370:Observation
keywords: Alarm fatigue; Alarm noise; Emergency; Monitor alarms; Patient deterioration; Patient monitoring