The proportion of clinically relevant alarms decreases as patient clinical severity decreases in intensive care units: a pilot study
Objectives To determine (1) the proportion and number of clinically relevant alarms based on the type of monitoring device; (2) whether patient clinical severity, based on the sequential organ failure assessment (SOFA) score, affects the proportion of clinically relevant alarms and to suggest; (3) m...
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BMJ Publishing Group
2013-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/3/9/e003354.full |
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| author | Ryota Inokuchi Kent Doi Kazuaki Shinohara Kensuke Nakamura Takehiro Matsubara Susumu Nakajima Hajime Sato Masataka Gunshin Takahiro Hiruma Takeshi Ishii Yoichi Kitsuta Naoki Yahagi Yuko Nanjo Masahiro Echigo Aoi Tanaka Mitsuo Umezu |
| author_facet | Ryota Inokuchi Kent Doi Kazuaki Shinohara Kensuke Nakamura Takehiro Matsubara Susumu Nakajima Hajime Sato Masataka Gunshin Takahiro Hiruma Takeshi Ishii Yoichi Kitsuta Naoki Yahagi Yuko Nanjo Masahiro Echigo Aoi Tanaka Mitsuo Umezu |
| author_sort | Ryota Inokuchi |
| collection | DOAJ |
| description | Objectives To determine (1) the proportion and number of clinically relevant alarms based on the type of monitoring device; (2) whether patient clinical severity, based on the sequential organ failure assessment (SOFA) score, affects the proportion of clinically relevant alarms and to suggest; (3) methods for reducing clinically irrelevant alarms in an intensive care unit (ICU).Design A prospective, observational clinical study.Setting A medical ICU at the University of Tokyo Hospital in Tokyo, Japan.Participants All patients who were admitted directly to the ICU, aged ≥18 years, and not refused active treatment were registered between January and February 2012.Methods The alarms, alarm settings, alarm messages, waveforms and video recordings were acquired in real time and saved continuously. All alarms were annotated with respect to technical and clinical validity.Results 18 ICU patients were monitored. During 2697 patient-monitored hours, 11 591 alarms were annotated. Only 740 (6.4%) alarms were considered to be clinically relevant. The monitoring devices that triggered alarms the most often were the direct measurement of arterial pressure (33.5%), oxygen saturation (24.2%), and electrocardiogram (22.9%). The numbers of relevant alarms were 12.4% (direct measurement of arterial pressure), 2.4% (oxygen saturation) and 5.3% (electrocardiogram). Positive correlations were established between patient clinical severities and the proportion of relevant alarms. The total number of irrelevant alarms could be reduced by 21.4% by evaluating their technical relevance.Conclusions We demonstrated that (1) the types of devices that alarm the most frequently were direct measurements of arterial pressure, oxygen saturation and ECG, and most of those alarms were not clinically relevant; (2) the proportion of clinically relevant alarms decreased as the patients’ status improved and (3) the irrelevance alarms can be considerably reduced by evaluating their technical relevance. |
| format | Article |
| id | doaj-art-fdab58403b5248afb8f74e4f32fecc2e |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2013-09-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-fdab58403b5248afb8f74e4f32fecc2e2025-02-04T12:55:10ZengBMJ Publishing GroupBMJ Open2044-60552013-09-013910.1136/bmjopen-2013-003354The proportion of clinically relevant alarms decreases as patient clinical severity decreases in intensive care units: a pilot studyRyota Inokuchi0Kent Doi1Kazuaki Shinohara2Kensuke Nakamura3Takehiro Matsubara4Susumu Nakajima5Hajime Sato6Masataka Gunshin7Takahiro Hiruma8Takeshi Ishii9Yoichi Kitsuta10Naoki Yahagi11Yuko Nanjo12Masahiro Echigo13Aoi Tanaka14Mitsuo Umezu151 Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, JapanDepartment of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan1 Emergency and Critical Care Medicine, Ohta Nishinouchi Hospital, Koriyama, Fukushima, JapanEmergency and Critical Care Medicine, Hitachi General Hospital, Hitachi, Ibaraki, JapanDepartment of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, JapanDepartment of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, JapanDepartment of Health Policy and Technology Assessment, National Institute of Public Health, Wako, Saitama, JapanDepartment of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, JapanDepartment of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, JapanDepartment of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, JapanDepartment of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, JapanDepartment of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, JapanDepartment of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, JapanCooperative Major in Advanced Biomedical Sciences, Joint Graduate School of Tokyo Women`s Medical University and Waseda University, Shinjuku-ku, Tokyo, JapanDepartment of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, JapanCooperative Major in Advanced Biomedical Sciences, Joint Graduate School of Tokyo Women`s Medical University and Waseda University, Shinjuku-ku, Tokyo, JapanObjectives To determine (1) the proportion and number of clinically relevant alarms based on the type of monitoring device; (2) whether patient clinical severity, based on the sequential organ failure assessment (SOFA) score, affects the proportion of clinically relevant alarms and to suggest; (3) methods for reducing clinically irrelevant alarms in an intensive care unit (ICU).Design A prospective, observational clinical study.Setting A medical ICU at the University of Tokyo Hospital in Tokyo, Japan.Participants All patients who were admitted directly to the ICU, aged ≥18 years, and not refused active treatment were registered between January and February 2012.Methods The alarms, alarm settings, alarm messages, waveforms and video recordings were acquired in real time and saved continuously. All alarms were annotated with respect to technical and clinical validity.Results 18 ICU patients were monitored. During 2697 patient-monitored hours, 11 591 alarms were annotated. Only 740 (6.4%) alarms were considered to be clinically relevant. The monitoring devices that triggered alarms the most often were the direct measurement of arterial pressure (33.5%), oxygen saturation (24.2%), and electrocardiogram (22.9%). The numbers of relevant alarms were 12.4% (direct measurement of arterial pressure), 2.4% (oxygen saturation) and 5.3% (electrocardiogram). Positive correlations were established between patient clinical severities and the proportion of relevant alarms. The total number of irrelevant alarms could be reduced by 21.4% by evaluating their technical relevance.Conclusions We demonstrated that (1) the types of devices that alarm the most frequently were direct measurements of arterial pressure, oxygen saturation and ECG, and most of those alarms were not clinically relevant; (2) the proportion of clinically relevant alarms decreased as the patients’ status improved and (3) the irrelevance alarms can be considerably reduced by evaluating their technical relevance.https://bmjopen.bmj.com/content/3/9/e003354.full |
| spellingShingle | Ryota Inokuchi Kent Doi Kazuaki Shinohara Kensuke Nakamura Takehiro Matsubara Susumu Nakajima Hajime Sato Masataka Gunshin Takahiro Hiruma Takeshi Ishii Yoichi Kitsuta Naoki Yahagi Yuko Nanjo Masahiro Echigo Aoi Tanaka Mitsuo Umezu The proportion of clinically relevant alarms decreases as patient clinical severity decreases in intensive care units: a pilot study BMJ Open |
| title | The proportion of clinically relevant alarms decreases as patient clinical severity decreases in intensive care units: a pilot study |
| title_full | The proportion of clinically relevant alarms decreases as patient clinical severity decreases in intensive care units: a pilot study |
| title_fullStr | The proportion of clinically relevant alarms decreases as patient clinical severity decreases in intensive care units: a pilot study |
| title_full_unstemmed | The proportion of clinically relevant alarms decreases as patient clinical severity decreases in intensive care units: a pilot study |
| title_short | The proportion of clinically relevant alarms decreases as patient clinical severity decreases in intensive care units: a pilot study |
| title_sort | proportion of clinically relevant alarms decreases as patient clinical severity decreases in intensive care units a pilot study |
| url | https://bmjopen.bmj.com/content/3/9/e003354.full |
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