title: Effect of altering alarm settings: a randomized controlled study.
abstract: Medical alarm signals are important for alerting clinicians to life-threatening conditions, but the high rate of false alarms can be problematic. Reduction in alarm signals may lead to increased staff responsiveness to alarms and create a quieter environment for patients. The effect of these changes on patient outcomes is uncertain.
  
  
  METHODS
  We conducted a pilot, prospective, randomized, controlled trial in the cardiac care unit (CCU) to test a study protocol and data collection instruments and to examine the differences in alarms between usual care and altered settings. Subjects were randomized daily to either standard or altered CCU alarm settings. Secondary outcomes included the number of clinically significant events (CSEs) detected, event-triggered interventions (ETIs), frequency of alarms per monitored bed, and patient complications.
  
  
  RESULTS
  Over the two-week study time frame, 22 unique patients were enrolled. There were 1,710 alarms over 163 hours of monitoring in the standard group and 1,165 alarms over 169 hours in the study group (P < 0.001). There were more CSEs detected (14 vs. 3) and ETIs (12 vs. 2) in the study group, but sample size was too small to determine efficacy. No cardiac arrests or adverse patient outcomes were observed in either group. All patients were discharged from the hospital. Study protocol and outcomes were feasible and lessons were learned.
  
  
  CONCLUSIONS
  This study demonstrated feasibility of a study protocol for conducting a randomized controlled trial to evaluate CSEs, ETIs, frequency of alarms, and adverse patient outcomes when altering default alarm settings. A longer study can be performed using a similar study design.
authors.forename: Maria
authors.initials: M
authors.lastname: Cvach
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Rothwell
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Cullen
authors.forename: Mary Grace
authors.initials: MG
authors.lastname: Nayden
authors.forename: Nicholas
authors.initials: N
authors.lastname: Cvach
authors.forename: Julius Cuong
authors.initials: JC
authors.lastname: Pham
mesh_terms: D056902:Clinical Alarms; D003625:Data Collection; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D010865:Pilot Projects; D011446:Prospective Studies