title: Multi-parameter vital sign database to assist in alarm optimization for general care units.
abstract: Continual vital sign assessment on the general care, medical-surgical floor is expected to provide early indication of patient deterioration and increase the effectiveness of rapid response teams. However, there is concern that continual, multi-parameter vital sign monitoring will produce alarm fatigue. The objective of this study was the development of a methodology to help care teams optimize alarm settings. An on-body wireless monitoring system was used to continually assess heart rate, respiratory rate, SpO2and noninvasive blood pressure in the general ward of ten hospitals between April 1, 2014 and January 19, 2015. These data, 94,575 h for 3430 patients are contained in a large database, accessible with cloud computing tools. Simulation scenarios assessed the total alarm rate as a function of threshold and annunciation delay (s). The total alarm rate of ten alarms/patient/day predicted from the cloud-hosted database was the same as the total alarm rate for a 10 day evaluation (1550 h for 36 patients) in an independent hospital. Plots of vital sign distributions in the cloud-hosted database were similar to other large databases published by different authors. The cloud-hosted database can be used to run simulations for various alarm thresholds and annunciation delays to predict the total alarm burden experienced by nursing staff. This methodology might, in the future, be used to help reduce alarm fatigue without sacrificing the ability to continually monitor all vital signs.
authors.affiliation: Sotera Wireless Inc., 10020 Huennekens St., San Diego, CA, 92121, USA.
authors.forename: James
authors.initials: J
authors.lastname: Welch
authors.affiliation: Sotera Wireless Inc., 10020 Huennekens St., San Diego, CA, 92121, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Kanter
authors.affiliation: Sotera Wireless Inc., 10020 Huennekens St., San Diego, CA, 92121, USA.
authors.forename: Brooke
authors.initials: B
authors.lastname: Skora
authors.affiliation: Sotera Wireless Inc., 10020 Huennekens St., San Diego, CA, 92121, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: McCombie
authors.affiliation: Sotera Wireless Inc., 10020 Huennekens St., San Diego, CA, 92121, USA.
authors.forename: Isaac
authors.initials: I
authors.lastname: Henry
authors.affiliation: Sotera Wireless Inc., 10020 Huennekens St., San Diego, CA, 92121, USA.
authors.forename: Devin
authors.initials: D
authors.lastname: McCombie
authors.affiliation: Sotera Wireless Inc., 10020 Huennekens St., San Diego, CA, 92121, USA.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Kennedy
authors.affiliation: Sotera Wireless Inc., 10020 Huennekens St., San Diego, CA, 92121, USA. babs.soller@soterawireless.com.
authors.forename: Babs
authors.initials: B
authors.lastname: Soller
mesh_terms: D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods; D056902:Clinical Alarms; D000067917:Cloud Computing; D003198:Computer Simulation; D016208:Databases, Factual; D004868:Equipment Failure; D006339:Heart Rate; D006761:Hospitals; D006801:Humans; D008490:Medical Informatics; D008991:Monitoring, Physiologic / Q000379:methods*; D056152:Respiratory Rate; D055986:Vital Signs; D059015:Wireless Technology
keywords: Alarm fatigue; Patient monitoring; Rapid response system; Vital sign management