Key result
Bidirectional communication cuts median NICU alarm duration ~33% versus unidirectional protocols.
Why the study?
To evaluate the effect of implementing a bidirectional communication protocol that enables automated withdrawal of resolved alarms on alarm duration and pressure in a single room NICU.
Does automated withdrawal of resolved alarms reduce alarm duration and pressure in a single room NICU?
Does automated withdrawal of resolved alarms reduce alarm duration and pressure in a single room NICU?
Automated withdrawal of resolved alarms on handheld devices significantly reduces alarm duration and sounding time, effectively lowering alarm fatigue and pressure in a single-room NICU.
Associated with reduced NICU alarm fatigue; supports consensus but leaves open need for RCTs before adoption.
Aim In 2017, the Leiden University Medical Centre implemented a secondary alarm system using handheld devices to ensure accurate patient monitoring on the single room NICU. Initially, alarms remained active on the handheld devices until one of the caregivers in the alarm chain accepted the alarm. In 2020, a bidirectional communication protocol (BCP) was implemented, enabling automated withdrawal of resolved alarms. The aim of this study was to evaluate the effect of this implementation on the alarm duration and pressure. Methods Data of all alarms of the secondary alarm chain in the 90 days before and after the implementation were analysed and compared between both periods. Results Following the implementation of the BCP, 60% of the alarms were withdrawn before the designated nurse responded. Despite a significant higher total number of alarms, the median alarm duration decreased from 9 (7–14) to 6 (4–10) s, the acceptance rate of the designated nurse increased from 93% to 95% and the median time of alarm sounding per phone per hour significantly decreased from 71 (51–101) to 51 (35–69) s following implementation of the BCP. Conclusion This study showed that automated withdrawal of resolved alarms significantly reduces alarm duration and pressure on a NICU.
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Broer et al. (2023) studied this question. The bidirectional communication protocol reduced median alarm duration from 9 to 6 seconds and decreased median alarm sounding time per phone from 71 to 51 seconds in the NICU.
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