The ICU can be an extremely stressful and intimidating environment for patients, family members and clinicians.
An unfortunate side effect of the ever-advancing pace of medical technology is the increasing clamor of clinical alarms from the many medical devices situated around the patient’s bedside in the intensive care unit (ICU). Some of these alarms are neither clinically nor technically actionable, as many as 80% - 99% being alarms of no consequence, and with up to 350 alarms per bed per day.
The workload and mental stress from handling excessive alarms can lead to desensitization, known as "Alarm Fatigue", which can severely impact patient safety. Alarm fatigue is a pressing problem and, in 2012, was considered the number one medical device technology hazard as described by Cvach in his review article published in that year.. With this information available, there should be no surprise that watchdog organizations such as ECRI have listed “Alarm, Alert, and Notification Overload” among their Top 10 Health Technology Hazards for 2020.
In addition to alarm fatigue, frequent alarms may increase the risk of sleep deprivation and delirium for patients in the ICU. The World Health Organization (WHO) suggests that average hospital sound levels should not exceed 35 dB, with a maximum of 40 dB in the overnight hours. Unfortunately, several studies show that in the years from 1960 to 2003, noise levels in ICUs increased from 57 dB to 72 dB during the daytime and from 42 dB to 60 dB at night.
Creating a healing environment for patients and an efficient workplace for health care professionals
At Getinge, we are constantly seeking new ways to help improve the environment and workflows within the patient care landscape. In recent years, we have worked closely with leading industry partners and standardization organizations to find solutions to the challenges of alarms and alarm fatigue in the ICU.
In the Quiet ICU concept, we are focusing on redirecting the audible alarm from the patient bedside to the relevant clinician while the medical equipment remains silent. This Quiet ICU concept is described in the Interoperability Showcase video “Trauma Recovery in the Quiet ICU”, provided by the Healthcare Information and Management Systems Society (HIMSS).
Distributing alarms from the patient bedside to the appropriate healthcare professional at the right time while maintaining patient safety is the guiding principle of Quiet ICU. The desired outcome is to improve efficiency while creating a low-stress, restful environment to promote healing.
Interoperability and communication interfacing
Inclusion, rather than exclusion, is an important principle when interoperability is discussed. To this end, Getinge has endeavored to utilize nonproprietary interfaces and is open to collaboration with other vendors. Establishing and maintaining interoperability between varied medical devices is a key factor in the effort to provide a more ideally Quiet ICU.
Getinge is currently collaborating with key industry partners and is an active particpant in the IHE, Integrating Healthcare Enterprise Patient Care Device (PCD) technical framework group, as well as with other groups driving standardization in this field.
Demonstration of the Quiet ICU concept
The Quiet ICU concept is compellingly demonstrated in the Interoperability Showcase video “Trauma Recovery in the Quiet ICU” provided by the Healthcare Information and Management Systems Society (HIMSS).
This informational and educational demonstration illustrates the importance of establishing standards for safely distributing and managing alarms between solutions provided by different medical device manufacturers
Getinge News and Press Release
- The future of intensive care comes with a Quiet ICU
- Getinge and partners showcase connectivity solutions for the quiet ICU of the future
- Trauma Recovery in the Quiet ICU - video
- HIMSS20 Digital Interoperability Showcase
- HIMSS educational opportunities
O.M. Cho, H. Kim, Y.W. Lee, and I. Cho, Clinical Alarms in Intensive Care Units: Perceived Obstacles of Alarm Management and Alarm Fatigue in Nurses, Healthc Inform Res 22 (2016), 46-53.
M. Cvach, Monitor Alarm Fatigue: An Integrative Review, Biomedical Instrumentation \& Technology 46 (2012), 268--277.
Wilken M, Hüske-Kraus D, Röhrig R. Alarm Fatigue: Using Alarm Data from a Patient Data Monitoring System on an Intensive Care Unit to Improve the Alarm Management. Stud Health Technol Inform. 2019 Sep 3;267:273-281.
Darbyshire and Young. An investigation of sound levels on intensive care units with reference to the WHO guidelines. Critical Care 2013, 17:R187
Berglund B, Lindvall T, Schwela DH: Guidelines for Community Noise Geneva: World Health Organization; 1999 [http://whqlibdoc.who.int/hq/1999/a68672.pdf].