Distractors in our Environment
The use of information technology or IT is becoming a norm or standard in the healthcare field. “IT advocates claim that it can support the work of healthcare professionals and benefit consumers by improving efficiency, quality, and safety.”[Heb13]. Though technology has proved to be very beneficial, we must not disregard the disadvantages that may arise and its effect on patient safety. Most healthcare environments, particularly hospitals, are very busy with a very fast-paced setting accompanied by various sounds of patient call bells, patient alarms, phone ringing, fax machines, physicians and other disciplines conversing, and many more. These sounds and noises can be distracting and overwhelming, but these alarms and bells are the technology we have put in place to keep our patients safe. This overwhelming noise and overstimulation have led to increased distractions when providing care to patients and alarm fatigue. “Alarm fatigue is sensory overload when clinicians are exposed to an excessive number of alarms, which can result in desensitization to alarms and missed alarms. Patient deaths have been attributed to alarm fatigue.” [Sen]. During one of my shifts, I know I will hear noise and see flashing lights from the automated vital signs machine, hourly rounding reminder, turn and reposition patient reminder every 2 hours, pain reassessment reminder each hour after I have administered pain medication, SCD sleeve alarm if the patient removes them or the line gets kinked, bed or chair alarm when patients are getting up to help prevent falls, IV smart pump alarms for distal occlusions, the air in the line, or infusion complete, call bells ringing for patient needs, phones ringing, and the barcode scanning system each time I administer anything. I will encounter all these sounds and stimulation during my shift and mostly all at one time. We also must add staff interruptions. At the facility where I work, we are required to wear a tracking device on our badges. This allows other staff, physicians, and the secretary to find me. This is both beneficial but also can be an added distraction. The secretary calls me over the intercom regarding another patient while I am providing direct care in a patient room, or the physician locates me and enters that patient’s room to pull me aside and explain their order or ask about other patients. These added disruptions and distractions during patient care can lead to poor patient outcomes and an unsafe environment. For example, a fellow nurse I was working a shift with had begun administering medications to a patient. She was scanning them in when the secretary called her over the intercom, asking for her to take a patient to the restroom. She responded she was administering medication but could as soon as she was done. The patient who had to go to the restroom got up; the fall alarm went off, but the nurse continued to administer medications, and the patient fell and was injured. The nurse also administered the wrong medications to the patient she was in the room with. The nurse admitted to hearing the Alarm and stated it usually goes off when the patient is just readjusting, so she thought it was a false alarm. “Quality improvement projects have demonstrated that strategies such as daily electrocardiogram electrode changes, proper skin preparation, education, and customization of alarm parameters have been able to decrease the number of false alarms” [Sen]. Although the alarms, bells, and lights are distracting, we must remember that there is a patient in a potentially unsafe situation, and we are there to keep our patients safe. We must continue to strive to improve patient care technology and find ways to decrease alarm fatigue.
References:
Hebda, T., & Czar, P. (2013). Handbook of informatics for nurses & healthcare professionals (5th ed.). Boston, MA: Pearson.
Sendelbach, S., & Funk, M. (2013). Alarm Fatigue: A Patient Safety Concern. AACN Advanced Critical Care, 378-386. Retrieved from https://www.aacn.org/education/ce- activities/acc3342/alarm-fatigue-a-patient-safety-concern
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Question 
Distractions are everywhere. They may include cellphones, alarms sounding for multiple different reasons, overhead paging, monitors beeping, and staff interrupting our thoughts.
Distractors in our Environment
Give an example of an ethical or legal issue that may arise if a patient has a poor outcome or sentinel event because of a distraction such as alarm fatigue. What does the evidence reveal about alarm fatigue and distraction when it comes to patient safety?