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Research Database Assignment Form

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Research Database Assignment Form

Describe briefly your topic of interest (15 possible points): The area that was chosen for this assignment is alarm fatigue. Alarm fatigue has been described as the process that occurs when nurses are desensitized due to too many alarms that are sounding constantly. Often times, there is no clinical indication for alarms that are sounding. This leads nurses to make the assumption that certain alarms are not important or the alarms very simply become background noise. Alarm fatigue has become nationally recognized and is the National Patient Safety Goal (NPSG) that was implemented by JCAHO for 2014. Medical alarms that are supposed to make nurses aware that something is wrong with the patient and prevent sentinel events have resulted in sentinel events. Some research has been done to show that alarms that were ignored is what led to the sentinel event occurring. I chose to research this area as I have witnessed this in the workplace over the years. I am reluctant to see what the outcomes of research on this subject will lead to and what protocol implementations will occur to meet the 2016 JCAHO deadline for this problem to be addressed.

#1 Database (or collection) (30 possible points):
Title of source: Association for the Advancement of Medical Instrumentation (AAMI)

Location of source (URL): http://www.aami.org/htsi/alarms/library.html

Owner or publisher: Healthcare Technology Safety Institute (HTSI)

Describe (in your own words) the research database or collection of research including the purpose and the subject matter it covers: AAMI, the Association for the Advancement of Medical Instrumentation, is a nonprofit organization that provides evidence based practices to healthcare professionals, biomedical engineering, nurses, physicians, and hospital administrators. AAMI is a leading resource in regards to technology and medical equipment. AAMI is currently conducting research regarding parameter setting of equipment.

Explain how the source relates to your topic of interest: AAMI is relevant to my topic of interest because it provides journal articles, books, continuing education opportunities, and best-practice information on understanding, development, management, and the use of medical equipment and the use of technology in a safe and effective manner. AAMI has many useful tools that and resources regarding alarm management and clinical alarms. JCAHO has recognized AAMI as a resource for use in decreasing alarm fatigue and as a resource for policy improvement.

#2 Database (or collection) (30 possible points):
Title of source: American Association of Critical-Care Nursing (AACN)

Location of source (URL): http://www.aacn.org/

Owner or publisher: American Association of Critical-Care Nursing (AACN)

Describe (in your own words) the research database or collection of research including the purpose and the subject matter it covers: AACN, the American Association of Critical-Care Nursing, is the world’s largest specialty nursing organization. AACN is committed to providing support to healthcare individuals and hospitals in order to manage alarm safety. AACN has worked with other subject matter experts to develop practical tools that are evidence-based to assist healthcare providers and hospitals in addressing and resolving technical challenges that have led to alarm fatigue.
Explain how the source relates to your topic of interest: AACN produces journal articles and uses evidence based research to promote continuing education. AACN also provides grants into research that is necessary in improving patient outcomes. AACN is currently educating the healthcare population regarding alarm fatigue through educational seminars and webinars. The Clinical Toolkit focuses on clinical alarm safety and was designed to build on research and learning conducted by the AACN. The toolkit provides evidence-based research and strategies as well as best practices and implantation tools to reduce the impact of clinical or environmental alarms.

#3 Database (or collection) (30 possible points):
Title of source: Multiparameter Intelligent Monitoring in Intensive Care (MIMIC-II)

Location of source (URL): https://mimic.physionet.org/

Owner or publisher: Physionet

Describe (in your own words) the research database or collection of research including the purpose and the subject matter it covers: The MIMIC-II research database (Multiparameter Intelligent Monitoring in Intensive Care) was created by obtaining data from a hospital’s ICU information systems, hospital archives and other external data sources. MIMIC-II database provided data for AAMI to incorporate into their evidence-based research. MIMIC-II is a research database that is public, freely available, contains a diverse and large population of ICU patients, and consists of high resolution data that is comprised of laboratory results, electronic documentation, and bedside monitor and waveform trends.

Explain how the source relates to your topic of interest: MIMIC-II supports clinical decisions with rule improvement and electronic tool development. The database is also helping target causes of alarm fatigue through analytic studies that are done in bedside monitors. The database is able to see how many times an alarm is silenced, acknowledged or how long it was alarming for. The database is also able to show how many of the reported alarms are false alarms. These studies will lead to correction of false alarms which will result in a decrease in the number of alarms, therefore reducing the occurrence of alarm fatigue.

#4 Database (or collection) (30 possible points):
Title of source: Emergency Care Research Institute (ECRI)

Location of source (URL): https://www.ecri.org/Pages/default.aspx

Owner or publisher: Emergency Care Research Institute (ECRI)

Describe (in your own words) the research database or collection of research including the purpose and the subject matter it covers: ECRI, Emergency Care Research Institute, is a nonprofit organization that has been conducting research for 45 years. The research institution looks at medical procedures, drugs, devices and processes. Through evidence-based research, practical experience and science are tested and applied to improve overall patient outcomes.

Explain how the source relates to your topic of interest: ECRI, Emergency Care Research Institute, has extensive experience in analyzing hazards that can arise from medical devices. Many of the reports that ECRI conducts is based on monitors such as monitors and ventilators. This reporting data looks at problems that may be linked to alarms. ECRI has created an Alarm Safety Handbook, which is a tool to help guide in the development of practices and protocols that can lead to safe, more effective alarm management. The handbook helps and institution create a plan, understand alarm hazards, put a plan into action, and it identifies best practice that will result in improved patient safety.

#5 Database (or collection) (30 possible points):
Title of source: Kelly Creighton Graham, RN, BS, is a nurse clinician III, quality improvement and safety representative in the medical progressive care unit and Maria Cvach, MSN, RN, CCRN, is assistant director of nursing, clinical standards, at The Johns Hopkins Hospital, Baltimore, Maryland.

Location of source (URL): http://ajcc.aacnjournals.org/content/19/1/28.full.pdf

Owner or publisher: American Journal of Critical Care (AJCC)

Describe (in your own words) the research database or collection of research including the purpose and the subject matter it covers: Both Maria Cvach, RN, MSN, CCRN and her colleague Kelly Creighton Graham, RN, BS, conducted research and used evidence-based research to create a best practice that was published as “Monitor Alarm Fatigue: Standardizing Use of Physiological Monitoring and Decreasing Nuisance Alarms”. Their work was implemented at Johns Hopkins Hospital and implementation of their best practice has led to a decrease in alarms resulting in a decrease in alarm fatigue.

Explain how the source relates to your topic of interest: Implementation of the best practice that has been described by Cvach and Graham would result in alarm fatigue. The use of smart alarm technology is constructed by setting physiological parameters in equipment that will result in a reduction of false of insignificant alarms. This process also includes revising default settings in monitors to reduce the occurrence of duplicate alarms occurring which can lead to false alarms therefore resulting in alarm fatigue. The research conducted by Cvach and Graham is useful in the design of hospital protocols that need to be in place by 2016 to adhere to the NPSG set by JCAHO in 2014 regarding alarm fatigue.

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