Hospital Noise Pollution a Growing Problem
One of the largest complaints of hospital patients and staff nationwide is the abundance of noise in the hospital. Uncomfortable and unsafe noise levels inhibit the healing process of patients that need it most.
In fact a recent study at Johns Hopkins University Hospital has shown that loud hospital environments can have a major negative impact on patients including:
• Elevated blood pressure levels.
• Sleep disruption.
• Decreased oxygen saturation.
• Decreased rates of wound healing.
The consequences of a loud environment on staff include emotional exhaustion and burnout as well as a raised risk of medical errors due to miscommunication. Recently, a patient at Massachusetts General Hospital died because his heart monitor had been turned off by a staff member. The investigators cited “alarm fatigue” as a cause of the problem. Alarm fatigue occurs when nurses become overwhelmed by the number and variety of alarms in the healthcare environment. As a result, nurses begin ignoring or even turning off alarms.
A Mayo Clinic study performed several years ago showed peak noise levels at night in one facility rising to 113 decibels, equivalent to a chainsaw or jackhammer.
Major sources of noise include hospital ventilation systems as well as overuse of the hospital paging system and an abundance of alarms. The Johns Hopkins study noted that though audible alarms were significantly quieter than other sources of noise, patients ranked them as being more irritating than more intense sources.
New Technology as a Solution to Hospital Noise Pollution
Dalcon provides solutions that, as a secondary benefit, help eliminate hospital noise pollution.
Dalcon Alert! for Remote Patient Monitoring connects with various patient monitoring devices such as heart monitors, IV pumps, ventilators, pulse oximeters, and more. When a patient monitoring device triggers an alarm connected to Dalcon Alert!, the system sends a text message to wireless phones (or pagers) held by hospital staff.
Because Dalcon Alert! allows hospital staff to more efficiently manage hospital alarms, alarm fatigue is significantly reduced. Also, since Dalcon Alert! incorporates wireless phones or pagers to be carried by hospital staff, use of the overhead pager can be dramatically decreased as well.
MGH Patient Death Raises Concerns about Patient Monitoring Device Alarm Effectiveness
A male patient at Massachusetts General Hospital died last January after the crisis alarm on his heart monitor was accidentally switched off and left off. The patient was not discovered to be in crisis until a nurse came by during a routine check. The hospital has not said how long the man had been in crisis before the nurse came by.
The patient’s death highlights a growing problem for hospitals nationwide. Failure by staff to acknowledge and respond to alarms is one of the most frequent and serious problems facing hospitals today. The ECRI Institute, an independent nonprofit organization that researches ways to improve patient care, recently released its list of “Top Ten Health Technology Hazards” for 2010. “Alarm Hazards” ranked in at No. 2, passing other high-ranking health risks such as “High Radiation Dose from Computed Tomography” and “Retained Devices and Un-retrieved Fragments Left in Patients.”
A Nationwide Problem
Across the nation, hospitals are taking extra time to examine the effectiveness of alarms on patient monitoring devices. Every year, deaths are reported because alarms either malfunction or are turned off, unheard, or ignored. Kathryn Pelczarski, director of ECRI’s applied solutions group, says that there were 237 alarm-related deaths between 2002 and 2004, and alarms made up 12 percent of the 2,200 medical device problems reported to ECRI between 2000 and 2006.
“Alarm Fatigue” a leading Cause of the Problem
As hospital technology has expanded both in terms of application and complexity, the number and types of alarms have also expanded. As a result, nurses and other caregivers often find themselves overwhelmed to the point that alarms lose their urgency. Pelczarski, calls this problem “alarm fatigue.” When alarm fatigue occurs, nurses begin ignoring and even turning off alarms. Additionally, since nurses are busy responding to a vast array of alarms, it can become difficult for them to hear and recognize each individual alarm.
New Remote Patient Monitoring Technology as a Solution
Today, new technologies and tools are emerging to help hospitals overcome this obstacle in providing quality patient care.
Dalcon Alert! is one such tool that provides caregivers with an efficient way to acknowledge and respond to multiple alarms. Dalcon Alert! is a Remote Patient Monitoring system that simultaneously connects with various patient monitoring devices such as heart monitors, IV pumps, ventilators, pulse oximeters, and more. When a patient monitoring device triggers an alarm connected to Dalcon Alert!, the system sends a text message to wireless phones (or pagers) held by hospital staff.
The system is highly customizable. For example, less critical alarms can be sent only to the nurses who are responsible for the patient whose device generated the alarm. Highly critical alarms, such as heart monitor alarms, can be sent to the entire nursing staff to assure that such alarms do not go unnoticed.
Dalcon Alert! also routes alarms to a PC display at the nursing station running the system’s Alert Management software, allowing nurses to manage all active alarms. Alarms cannot be removed from the Alert Management queue until dealt with at the point of care. As a result, accidental staff negligence is eliminated.
Culture Change in Nursing Homes
Culture change in nursing homes refers to the new and revolutionary patient care practices developing in modern long term care. The overarching goal is to transform these facilities from institutions into real homes and communities.
This change is guided by a shift in focus aimed at enhancing the respect and care given to elderly patients. Culture change stresses the importance of patient choice, dignity, autonomy, and purposeful living. One of the goals of this movement is to expand patient care beyond just physical boundaries; the patient’s mental and emotional well-being also becomes a priority. By attending to every aspect of a patient’s needs while maintaining high respect for the patient, more trust is established between patient and caregiver and the patient will be more satisfied with the care that he or she is receiving.
Healthcare facilities and nursing homes that are involved in this culture change will notice that small changes can lead to big results. For example, changing certain aspects about the language used in the workplace will create a community atmosphere where patients and workers are known as “friends.” Referring to patients as “friends” or “neighbors” and nursing homes as “communities” or “life centers” is a subtle way to deinstitutionalize the atmosphere.
Personalized Care is the Most Important
Creating “neighborhoods” within the nursing home, consistently staffed by the same caregivers, helps enhance the relational aspect of the culture change. Personalized one-on-one care is an important part of nursing home culture change. By having the same caregivers care for the same group of patients, the patients become more familiar and friendly with the workers, and healthy relationships are encouraged.
Also, many times nursing homes that are creating these neighborhoods will allow the staff of each area to maintain high levels of self-management, which increases job satisfaction.
Patient choice plays an important role in nursing home culture change. Certain choice options, such as allowing patients to choose what to eat for dinner, what activities to participate in, or when they would like to go to bed can go a long way toward improving the patients’ perceived quality of life. Also, more nursing homes are making efforts to provide each resident with a private room, as this allows the patient to feel more independent.
New Technology Assists in Nursing Home Culture Change
New remote patient monitoring technology, such as Dalcon Alert!, helps nursing homes “deinstitutionalize” and create a homelike environment by eliminating loud alarms and the need to use the overhead pager. The system also greatly improves staff communication and the quality of care.
The culture change in long term care movement is gaining momentum, mostly because of the benefits that it brings to both residents and employees. Nursing homes that adopt the principles of culture change often see improvements throughout the entire organization, such as reduced operational costs, increased staff retention rates, higher occupancy rates, and increases in overall competitive position.
Creating a Homelike Environment in Nursing Homes with New technology
In June 2009, the Centers for Medicare & Medicaid Services (CMS) issued new revolutionary guidelines for long term care facilities (nursing homes) that receive federal funds. These guidelines called upon nursing homes to create a “Homelike Environment” for residents; creating a call to action to deinstitutionalize these facilities by making changes such as:
• Removing overhead paging and piped in music.
• Removing institutionalized signage and labeling (such as closet and bathroom labels).
• Removing medicine carts and large centralized nursing stations.
• Discontinuing long term use of patient monitoring systems that use audible alarms.
• Eliminating mass-purchased furniture displayed throughout the building.
Dalcon’s unique patient care communications solution, Dalcon Alert!, is designed to help nursing homes make several of these changes. As a result, facilities using the Dalcon Alert! system will meet numerous new CMS Homelike Environment guidelines, and their quality of patient care will drastically increase.
Dalcon Alert! provides a communications platform that eliminates the need for:
- Overhead Paging
- Audible patient monitoring alarms
- A large centralized nursing station
How Does Dalcon Alert! Eliminate Audible Alarms?
Dalcon Alert! is a patient care communications system that has several features. The system provides Remote Patient Monitoring and Alarm Management by integrating with patient monitoring devices including but not limited to:
• bed exit pads
• bed fall pads
• IV-Pumps
• Patient Nurse Calls
When an alert is created by any integrated device, Dalcon Alert! routes that alert to a remote nursing station where it can be actively managed on a PC monitor using Dalcon Alert!’s alert management software. Dalcon Alert! also sends that alert to select staff carrying fully functional wireless phones via text message, so they are immediately made aware of that alert regardless of their location—and without the use of audible alarms.
How Does Dalcon Alert! Reduce the need for Overhead Paging and a Large Centralized Nursing Station?
Equipping vital staff with wireless phones is a central piece of the Dalcon Alert! system. These phones allow staff to receive important alerts regardless of their location. Caregivers can be reached remotely by phone, vastly eliminating the need for overhead paging.
A key component of the successful implementation of a decentralized nursing station system is staff communication. Dalcon Alert! provides staff with an effective decentralized communications platform, built around fully functional wireless phones. Also, Dalcon Alert!’s alert management software is accessed via a browser, and there is no limit to how many computers can be logged on to it at once. Thus, each decentralized nursing station can be actively managing alerts at any given time.
