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Why Acute Care facilities should be implementing Alarm Management Policies
What are clinical alarm hazards, alarm fatigue and alarm management? Why your hospital should be concerned?
Hospitals and acute care facilities are loud and action filled environments. A large part of this activity and noise comes from the various alarms generated from medical devices and equipment, often connected to the patient. In units such as Intensive Care, Emergency, and Cardiac Care, patients may be connected to dozens of different devices, all of which alert caregivers to different events and changes in a patient’s condition. These clinical alarms can make the difference between lifesaving interventions by caregivers, or serious injury and death to patients. Due to the importance and sheer volume of alarms, it is crucial that there are appropriate alarm management procedures in place.
In this busy and alarm rich environment, it is easy for clinical alarm hazards to occur. Clinical alarm hazards can be defined as any circumstance, during the care of a patient that could result in the failure of staff to be informed of a valid alarm condition in a timely manner, or failure to take appropriate action in response to the alarm.
Why Nurse Call Systems are covered by Medical Device Regulation Internationally
Recent international changes to the definition and regulation of Medical Devices have determined Nurse Call Systems to be considered Medical Devices. Under this international legislation, all Nurse Call Systems are for the first time to be clinically regulated, audited and certified. The purchase, installation and use of non-clinically regulated Nurse Call Life Safety Systems across healthcare facilities is of growing concern for patient safety, clinical risk, and any Clinical Risk Committee actively pursuing corporate governance.
Regulation and audit of Nurse Call Systems within Australia, UK and EU have been historically largely unaudited, and to a lesser extent unregulated. As a consequence, many acute care facilities in these countries still consider the purchase and implementation of a Nurse Call System to be a “non-clinical acquisition”. The choice between Nurse Call providers is often decided by a building contract, where the lowest price wins the deal. This process is a significant risk for patient safety, a business risk for hospitals and governments, and a construction project risk. The United States, through the FDA is several years ahead of the regulation and audit process with its MDDS legislation implemented in 2011. They have introduced a robust and strict auditing process of Nurse Call manufacturers that are conducted annually.
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Improved patient care – Care Management and Information Systems
Hospitals are trying to address the nursing shortage with better staffing levels, more flexible scheduling and higher salaries. But it is also necessary to reduce the time nurses spend on administration, paperwork and other indirect tasks-and to increase the time they spend at their patients’ bedside. No single solution will immediately improve nurse recruitment and retention. However, better communications and easier access to relevant information can go a long way to addressing the issues that have aggravated the nursing shortage. Advanced nurse call systems provide the tools enabling performance improvement initiatives.
“Care Management and Information Systems” provide significant workflow productivity tools and benefits. Wireless telephony further supports the patient safety initiative of the named nurse, providing up to a 50% efficiency dividends for each nurse for each shift and in addition, provides a similar efficiency dividends for doctors enabling a saving of approximately $3 Million per medium sized hospital per annum.
Accompanying the workflow and efficiency dividends from the Care Management and Information System provides significant benefits from improved QA and patient safety. This is specially enabled by associating the efficiency dividend with more time for nurses to spend with patients, doing what they are trained to do – giving care. This care giving is proven to provide reductions in secondary infections like pneumonia and enhance the detection rates of MRSA and hence detecting and reacting to patients drifting off protocol, which leads to reductions in patient days further enhancing hospital efficiency.
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