通过确定达曼医院成人重症监护室的警报疲劳表现改善安全文化

Veena Lobo, Nor Aroma Abu Bakar, Eman Salman Al-Safwani, Khadeejah Hussain Al-Huraiz, Pienaar Judith, Shaher Al-Qahtani
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摘要

警报疲劳正成为一个日益严重的全球公共卫生问题,它损害了患者的安全。警报疲劳在重症监护护士中尤为常见,因为他们是为病人提供最直接护理和全天候病人监护的一线医疗服务提供者。过多的警报以及错误和无效的警报会导致警报疲劳,并对护士和患者在康复过程中的心理健康产生负面影响。为了找到降低错误警报数量的方法并评估所采取的措施的有效性,我们采用了一种定量、描述性横断面方法。该试点项目于 2019 年 6 月至 2020 年 11 月在达曼国家医疗卫生总局的成人重症监护室开展。为了识别真实警报和虚假警报,利用中央监控护士每日检查表作为数据收集工具,并结合教育培训和部门政策与程序。每位患者每天约有 820 次警报,其中包括 104 次遥测警报和 716 次床边警报。项目实施三个月后,该项目的最高警报测量值为每位患者每天 1503 次警报。在这一峰值之后,该项目警报数量呈持续下降趋势,这主要是项目改进活动的结果。2020 年 11 月记录的最低警报数为 226 次,比最初的 820 次警报减少了 72%。不过,前三个月的下降趋势显示,警报总数分别下降了 22%、42% 和 48%。这项研究发现,在达曼医院重症监护病房工作的重症监护护士中,警报疲劳现象较为普遍,而警报疲劳受包括安全文化实践在内的多种变量的影响。总体而言,在部署的头两个月,这项研究有效地实现了其目标,并对减少 "误报 "产生了相当大的影响。这项研究的结果,加上护士心理健康的改善和为病人提供的治疗环境,为今后旨在减少重症监护护士警报疲劳的干预计划提供了重要的方向。未来的研究应集中于坚持和管理的特征,以及阻碍重症监护室工作人员继续实施干预和减少误报策略的障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improving Safety Culture by Establishing Alarm Fatigue Performance in The Adult Intensive Care Unit, Dammam Hospital
Alarm fatigue is becoming a more significant global public health issue that compromises patient safety. Alarm fatigue is especially common among critical care nurses, who are the frontline healthcare providers that provide patients with the most direct care and round-the-clock patient monitoring. An excessive number of alerts, together with erroneous and ineffective alerts, can cause alarm fatigue and negatively impact the psychological well-being of nurses and patients during their recovery process. To find a way to lower the number of false alarms and assess the effectiveness of the measures put in place, a quantitative, descriptive cross-sectional approach was employed. In the adult ICU at NGHA Dammam, this pilot project was carried out from June 2019 to November 2020. In order to identify true alarms and false alarms, the Central Monitor Nurse Daily Checklist was utilized as a data collection tool in conjunction with education training and departmental policies and procedures. There are about 820 alerts per patient each day, including 104 telemetry and 716 bedside alarms. Three months into the project, the project's top alarm measurement was 1503 alarms per patient per day. The project has shown a constant trend in alarm declinations after this peak, largely as a result of project improvement activities. The lowest recorded alarm count in November 2020 was 226 alerts, a 72% decrease from the initial 820 alarms. Nonetheless, the declining trend over the previous three months showed a 22%, 42%, and 48% drop in the overall number of alarms. This study found that alarm fatigue, which is influenced by a number of variables, including safety culture practices, was more common among critical care nurses working in the Intensive Care Unit at NGHA Dammam. Overall, during the first two months of its deployment, this study effectively met its aim and had a considerable impact on the reduction of "false alarms". The results of this study, taken together with improved psychological health for nurses and the provision of a therapeutic environment for patients, offer crucial direction for future intervention programs aimed at reducing alarm fatigue among critical care nurses. Future studies should concentrate on the traits of adherence and management, as well as the obstacles that prevent ICU staff from continuing to implement interventions and false alarm reduction strategies.
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