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Current Challenges with Ventilator Alarms Webinar – March 25, 2014
Key Points Checklist
Problems with ventilator alarms
• Alarm settings too broad (may miss patient problem) or too narrow (nuisance alarms)
• Overwhelming number of alarms in patient care area
The Joint Commission National Patient Safety Goal on Alarm Management provides guidance and required
compliance dates
Alarm grades and priorities based on potential risk and urgency of needed action
Future changes in ventilator alarms need to balance patient safety, user comfort and attention, and comply
with international standards (IEC 60601-1-8)
Barriers related to ventilator alarms
• Inconsistent and complicated alarm packages with different ventilators
- Issues related to integration with secondary systems
- Variation in available alarm settings
- Inconsistent nomenclature
• Limited autonomy allowed at bedside (inability to customize algorithms and delays)
• Inconsistent ability to transmit alarm data to third party (electronic medical record, secondary alarm
notification)
Challenges for industry
• Lack of research to determine best practice for ventilator alarm settings
• Industry needs to collaborate with respiratory therapists and nurses
• Use standardized nomenclature for alarms and alarm events
• Need more options for secondary alarm notification
Current secondary alarm notification options allow ventilator alarms to be sent to caregiver’s mobile device
(all allow a delay to be set before dispatching the alarm and allow for designated caregivers to be notified)
• Auxiliary jack – nurse call (limitations: alarm is generic – sent only as “vent alarm” – and all ventilator
alarms are dispatched)
• Patient monitor (limitations: number of data elements is limited and only some ventilators can interface
with monitors)
• Integrators and middleware – can choose which alarms and at what priority they are dispatched
(limitations: need 2 types of software and must deal with multiple vendors that do not always
communicate)
Must manage primary ventilator alarms and determine responsibilities of respiratory therapists before
implementing or changing secondary notification system
• Customize alarm limits for individual patients
• Determine primary responder for all ventilator alarms
Must characterize current practice at your institution and use data to change practice

AAMI Foundation's Healthcare Technology Safety Institute (HTSI)
Association for the Advancement of Medical Instrumentation (AAMI) 
4301 N. Fairfax Drive, Suite 301, Arlington, VA 22203-1633 

. evaluate % change of patient parameter required to trigger alarm • No evidence re: whether using fixed thresholds or % change is preferable • Is current practice driven by clinician intuition and conditioning? Make data-driven changes to practice: use approach based on % change of patient parameter to guide setting of limits for alarms identified as “most frequently occurring actionable alarms” • Compare 25%. AE-C. Shawna Strickland. Fairfax Drive. FAHA. MSc. the policy should be the result of your intervention and analysis process • Compile and evaluate existing data to identify areas for improvement • Pilot test different interventions to address what you discovered in your baseline analysis • Create guidelines/policy for ventilator alarm management Webinar Faculty: 1. may not be able to determine if actionable vs. e.    Obtain alarm data on a pilot unit • Number of alarms per ventilator per day and timing of alarms during the day • Duration of alarm conditions • % of alarms that are actionable • Most frequently occurring actionable alarms • Evaluate bedside clinicians’ responses to ventilator alarms through direct observation • Evaluate respiratory therapists’ perceptions of frequency and utility of ventilator alarms • Know limitations of data. PhD. non-actionable. do not start with creating or updating a policy. FAAN AAMI Foundation's Healthcare Technology Safety Institute (HTSI) Association for the Advancement of Medical Instrumentation (AAMI)  4301 N. 200% • Evaluate % of actionable ventilator alarms vs. MHA. VA 22203-1633  . total ventilator alarms for each % change value • Identify most frequently occurring actionable ventilator alarms for each % change value Change must be driven by data. AE-C. 150%. 50%. 4. Trojanowski. Cazares. PhD. Arlington. 2. RRT-NPS. FAARC (Moderator) Thomas Krüger Russelle A. RRT-NRS. Suite 301.g. RRT Matthew P. and priority level of alarm without direct observation Evaluate current practice on pilot unit • Do respiratory therapists control alarm settings? • Do they set similar limits regardless of ventilator settings and patient characteristics? • If so. specific alarm condition. 3. RN. FAARC Key Points Checklist compiled by Marjorie Funk. 100%.