title: Safe patient monitoring is challenging but still feasible in a neonatal intensive care unit with single family rooms.
abstract: OBJECTIVE
  Patient monitoring generates a large number of alarms. The aim of this study was to evaluate the rate, type and management of alarms and to determine the risks of a distributed alarm system in a neonatal intensive care unit (NICU) with single family rooms.
  
  
  METHODS
  A risk analysis was performed before implementation. Alarms from patient monitors recorded for a year were identified, classified and counted. The first alarms, which went to the nurse responsible for the patient, were distinguished from the repeat alarms that were generated if the nurse failed to respond within 45 sec.
  
  
  RESULTS
  The alarm handling protocol was changed as staff felt they needed a greater overview of the NICU alarms to avoid risks. In 1 year, 222 751 critical alarms including 12 309 repeat alarms were generated by patient monitors, equivalent to two alarms per patient per hour. Most of the alarms were oxygen desaturation alarms, followed by bradycardia alarms. About 3% of the desaturation alarms and 0.2% of the bradycardia alarms were repeated.
  
  
  CONCLUSIONS
  Safe patient monitoring was challenging in a NICU with single family rooms, but possible by employing a distributed alarm system. The low number of repeat alarms indicated quick response times.
authors.affiliation: Clinical Physics, Máxima Medical Centre, Veldhoven, The Netherlands.|School of Medical Physics and Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: van Pul
authors.affiliation: Neonatal Intensive Care Unit, Máxima Medical Centre, Veldhoven, The Netherlands.
authors.forename: H P M E
authors.initials: HP
authors.lastname: V D Mortel
authors.affiliation: Medical and Information Technology, Máxima Medical Centre, Veldhoven, The Netherlands.
authors.forename: J J L
authors.initials: JJ
authors.lastname: V D Bogaart
authors.affiliation: Neonatal Intensive Care Unit, Máxima Medical Centre, Veldhoven, The Netherlands.|Medical and Information Technology, Máxima Medical Centre, Veldhoven, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Mohns
authors.affiliation: Neonatal Intensive Care Unit, Máxima Medical Centre, Veldhoven, The Netherlands.|Paediatrics, Faculty of Health, Medicine and Life Science, Maastricht University, Maastricht, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Andriessen
mesh_terms: D056902:Clinical Alarms / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration* / Q000706:statistics & numerical data; D008991:Monitoring, Physiologic / Q000706:statistics & numerical data*
keywords: Alarm; Monitoring; Neonatal intensive care unit; Risk; Safety