CEASE, Philips education, skills training improve alarm monitoring practices in surgical ICU

Editor's Note

A quality improvement study led by clinicians at the Mayo Clinic in Jacksonville, FL, improved clinical alarm management skills and reduced alarm fatigue and desensitization among nurses in a surgical intensive care unit.

The study included 115 direct-care nurses working full-time, modified full-time, or part-time schedules in a 27-bed surgical intensive care unit in a teaching hospital. The patient population included those undergoing various cardiothoracic-related and neurosurgeries, and those requiring mechanical devices.

The four-month project included an initial Healthcare Technology Foundation (HTF) clinical alarms survey to determine current levels of alarm management and fatigue, eight weeks of education and skills training on CEASE (Communication, Electrodes, Appropriateness, Setup, and Education) and the Philips monitoring system, and a post-intervention HTF clinical alarms survey with two additional questions to measure effectiveness of the training.

After the intervention, participants found that setting alarm parameters were less complex, felt more sensitive to alarms and responded quickly, and less likely to miss alarms.

82% of participants reported that the CEASE bundle helped decrease alarm fatigue and 83% reported they would continue to use it. 95% felt confident and competent after training on the Philips monitoring system.

“Clinical alarms are important, but they also contribute to a noisy hospital environment for patients and clinicians. With high sensitivity and low specificity, monitors can generate an overwhelming number of alarms, many of which are false or nonactionable alerts,” Stephanie Bosma, DNP, APRN, FNP-BC, lead researcher said. “Our project gave alarm management skills much-needed attention and introduced a new tool to help staff maximize the benefits of clinical alarms.”

The Joint Commission’s 2022 goal of improving clinical alarm safety remains a top priority nationwide.