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Alarm fatigue occurs when staff are exposed to a large volume of alarms and as a result, become desensitized to the firing alarms. Desensitization can lead to longer response times or missing important alarms. Alarm fatigue occurs in many industries including construction, mining  , and most notably, healthcare.

Alarm fatigue in healthcare
On April 18, 2013, the Joint Commission issued a sentinel event alert that highlighted the widespread problem of alarm fatigue in hospitals. Their recommendations included establishing guidelines to tailor alarm settings, training all members of the clinical team on safe use of alarms, and sharing information about alarm-related incidents. This alert has since turned into a National Patient Safety Goal for 2014 to improve the safety of clinical alarm systems. This Goal will force hospitals to establish alarm safety as a priority, identify the most important alarms, and establish policies to manage alarms by January 2016.

Unintended outcomes of alarms
The large number of alarms, especially of false alarms, has led to several unintended outcomes. Some consequences are disruption in patient care, desensitization to alarms, anxiety in hospital staff and patients, sleep deprivation and depressed immune systems, misuse of monitor equipment, and missed critical events. Some additonal outcomes include workload increase, interference with communication, wasted time, patient dissatisfaction, and unnecessary investigations, referrals, or treatments.

Changing alarm sounds and parameters
There are many solutions proposed to reduce alarm fatigue in healthcare settings. One recommendation is to change alarm sounds to be softer and friendlier in order to improve identification of alarms by sound alone. Another recommendation is for clinicians to adjust the parameters and delays to alarms to match the patient’s traits and status. However, this directly trades sensitivity for specificity.

Centralized alarms
Another solution that has been proposed is to use centralized alarms. In this approach, alarms don’t fire at the bedside, but fire at a central monitoring station where a trained healthcare provider evaluates each alarm and alerts the bedside clinician if they should intervene or evaluate the patient.

Changing alarm algorithms
Biomedical engineers may improve monitors by adjusting alarm algorithms. Currently, the alarm systems are very sensitive but not specific. This leads to a large amount of false alarms. The algorithms used can be adjusted to balance between sensitivity and specificity to limit the number of false alarms and still detect true deterioration.