[Reaction time of a health care team to monitoring alarms in the intensive care unit: implications for the safety of seriously ill patients].
OBJECTIVE
To define the characteristics and measure the reaction time of a health care team monitoring alarms in the intensive care unit.


METHODS
A quantitative, observational, and descriptive study developed at the coronary care unit of a cardiology public hospital in Rio de Janeiro state (RJ). Data were obtained from the information collected on the patients, the monitoring used, and the measurement of the team's reaction time to the alarms of multi-parameter monitors during a non-participatory field observation.


RESULTS
Eighty-eight patients were followed (49 during the day shift and 39 during the night shift). During the 40 hours of observation (20 hours during the day shift and 20 hours during the night shift), the total number of monitoring alarms was 227, with 106 alarms during the day shift and 121 during the night shift, an average of 5.7 alarms/hour. In total, 145 alarms unanswered by the team were observed, with 68 occurring during the day shift (64.15%) and 77 during the night shift (63.64%). This study demonstrated that the reaction time was longer than 10 minutes in more than 60% of the alarms, which were considered as unanswered alarms. The median reaction time of the answered alarms was 4 minutes and 54 seconds during the day shift and 4 minutes and 55 seconds during the night shift. The respiration monitoring was activated in only nine patients (23.07%) during the night shift. Regarding the alarm quality of these variables, the arrhythmia alarm was qualified in only 10 (20.40%) of the day-shift patients and the respiration alarm in four night-shift patients (44.44%).


CONCLUSIONS
The programming and configuration of the physiological variables monitored and the parameters of alarms in the intensive care unit were inadequate; there was a delay and lack of response to the alarms, suggesting that relevant alarms may have been ignored by the health care team, thus compromising the patient safety.
Escola de Enfermagem Alfredo Pinto, Universidade Federal do Estado Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Adriana Carla
AC
Bridi
Escola de Enfermagem Alfredo Pinto, Universidade Federal do Estado Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Roberto Carlos Lyra
RC
da Silva
Escola de Enfermagem Alfredo Pinto, Universidade Federal do Estado Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Carolina Correa Pinto
CC
de Farias
Escola de Enfermagem Alfredo Pinto, Universidade Federal do Estado Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Andrezza Serpa
AS
Franco
Escola de Enfermagem Alfredo Pinto, Universidade Federal do Estado Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Viviane de Lima Quintas
Vde L
dos Santos
D001938:Brazil; D056902:Clinical Alarms; D003325:Coronary Care Units / Q000458:organization & administration; D003422:Critical Care / Q000379:methods*; D006779:Hospitals, Public; D006801:Humans; D007362:Intensive Care Units; D008991:Monitoring, Physiologic / Q000295:instrumentation; D010348:Patient Care Team / Q000458:organization & administration / Q000706:statistics & numerical data*; D013997:Time Factors