{
    "abstract": "Alarms alert healthcare professionals of deviations from normal/physiologic status. However, alarm fatigue may occur when their high pitch and diversity overwhelm clinicians, possibly leading to alarms being disabled, paused, and/or ignored. We aimed to determine whether a staff educational program on customizing alarm settings of bedside monitors may decrease inconsistent alarms in the Post-Anesthesia Care Unit (PACU).\nThis is a prospective, analytic, quantitative, pragmatic, open-label, single-arm study. The outcome was evaluated on PACU admission before (P1) and after (P2) the implementation of the educational program. The heart rate, blood pressure, and oxygen saturation alarms were selected for clinical consistency.\nA total of 260 patients were included and 344 clinical alarms collected, with 270 (78.4%) before (P1), and 74 (21.6%) after (P2) the intervention. Among the 270 alarms in P1, 45.2% were inconsistent (i.e., false alarms), compared to 9.4% of the 74 in P2. Patients with consistent alarms occurred in 30% in the P1 and 27% in the P2 (p = 0.08). Patients with inconsistent alarms occurred in 25.4% in the P1 and in 3.8% in the P2. Ignored consistent alarms were reduced from 21.5% to 2.6% (p = 0.004) in the P2 group. The educational program was a protective factor for the inconsistent clinical alarm (OR = 0.11 [95% CI 0.04-0.3]; p < 0.001) after adjustments for age, gender, and ASA physical status.\nCustomizing alarm settings on PACU admission proved to be a protective factor against inconsistent alarm notifications of multiparametric monitors.",
    "authors": [
        {
            "affiliation": "Hospital S\u00e3o Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, S\u00e3o Paulo, SP, Brazil.",
            "firstname": "Saullo Queiroz",
            "initials": "SQ",
            "lastname": "Silveira"
        },
        {
            "affiliation": "Hospital S\u00e3o Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, S\u00e3o Paulo, SP, Brazil.",
            "firstname": "Rafael Sousa Fava",
            "initials": "RSF",
            "lastname": "Nersessian"
        },
        {
            "affiliation": "Hospital S\u00e3o Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, S\u00e3o Paulo, SP, Brazil.",
            "firstname": "Arthur de Campos Vieira",
            "initials": "ACV",
            "lastname": "Abib"
        },
        {
            "affiliation": "Hospital S\u00e3o Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, S\u00e3o Paulo, SP, Brazil; Rede D'Or, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil.",
            "firstname": "Leonardo Barbosa",
            "initials": "LB",
            "lastname": "Santos"
        },
        {
            "affiliation": "Hospital S\u00e3o Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, S\u00e3o Paulo, SP, Brazil.",
            "firstname": "Fernando Nardy",
            "initials": "FN",
            "lastname": "Bellicieri"
        },
        {
            "affiliation": "S\u00e3o Luiz Hospital (ITAIM), Rede D'Or, Departamento de Enfermagem, S\u00e3o Paulo, SP, Brazil.",
            "firstname": "Karen Kato",
            "initials": "KK",
            "lastname": "Botelho"
        },
        {
            "affiliation": "Rede D'Or, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil.",
            "firstname": "Helidea de Oliveira",
            "initials": "HO",
            "lastname": "Lima"
        },
        {
            "affiliation": "Hospital S\u00e3o Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, S\u00e3o Paulo, SP, Brazil.",
            "firstname": "Renata Mazzoni de",
            "initials": "RM",
            "lastname": "Queiroz"
        },
        {
            "affiliation": "Hospital S\u00e3o Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, S\u00e3o Paulo, SP, Brazil.",
            "firstname": "Gabriel Silva Dos",
            "initials": "GSD",
            "lastname": "Anjos"
        },
        {
            "affiliation": "University of Toronto, Mount Sinai Hospital, Department of Anesthesiology and Pain Medicine, Toronto, Canada.",
            "firstname": "Hermann Dos Santos",
            "initials": "HDS",
            "lastname": "Fernandes"
        },
        {
            "affiliation": "Queen's University, Department of Anesthesiology and Perioperative Medicine, Kingston, Canada.",
            "firstname": "Glenio B",
            "initials": "GB",
            "lastname": "Mizubuti"
        },
        {
            "affiliation": "Faculdade de Medicina da Universidade de S\u00e3o Paulo (FMUSP), Departamento de Cirurgia, Anestesiologia, S\u00e3o Paulo, SP, Brazil.",
            "firstname": "Joaquim Edson",
            "initials": "JE",
            "lastname": "Vieira"
        },
        {
            "affiliation": "Hospital S\u00e3o Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, S\u00e3o Paulo, SP, Brazil; Rede D'Or, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil. Electronic address: leopoldo.muniz@saoluiz.com.br.",
            "firstname": "Leopoldo Muniz",
            "initials": "LM",
            "lastname": "da Silva"
        }
    ],
    "conclusions": "Customizing alarm settings on PACU admission proved to be a protective factor against inconsistent alarm notifications of multiparametric monitors.",
    "copyrights": "Copyright \u00a9 2023 Sociedade Brasileira de Anestesiologia. Published by Elsevier Espa\u00f1a S.L.U. All rights reserved.",
    "doi": "10.1016/j.bjane.2023.07.013",
    "journal": "Brazilian journal of anesthesiology (Elsevier)",
    "keywords": [
        "Anesthesia recovery period",
        "Clinical alarms",
        "Data management",
        "Monitoring",
        "Post-anesthetic care unit"
    ],
    "methods": null,
    "publication_date": "2023-08-11",
    "pubmed_id": "37562650\n22465785\n21366502\n34151285\n26539788\n26663904\n29889722\n28455284\n33786815\n28567167\n30077422\n22839984\n26330431\n28981515\n28883181\n29112077\n25873486\n28394995\n28934401\n29606686\n19001484\n20045845\n27959311\n17695343\n31269123\n28567167\n25554556\n30122549\n34047701\n26341898",
    "results": "A total of 260 patients were included and 344 clinical alarms collected, with 270 (78.4%) before (P1), and 74 (21.6%) after (P2) the intervention. Among the 270 alarms in P1, 45.2% were inconsistent (i.e., false alarms), compared to 9.4% of the 74 in P2. Patients with consistent alarms occurred in 30% in the P1 and 27% in the P2 (p = 0.08). Patients with inconsistent alarms occurred in 25.4% in the P1 and in 3.8% in the P2. Ignored consistent alarms were reduced from 21.5% to 2.6% (p = 0.004) in the P2 group. The educational program was a protective factor for the inconsistent clinical alarm (OR = 0.11 [95% CI 0.04-0.3]; p < 0.001) after adjustments for age, gender, and ASA physical status.",
    "title": "Decreasing inconsistent alarms notifications: a pragmatic clinical trial in a post-anesthesia care unit.",
    "xml": "<Element 'PubmedArticle' at 0x788503ce8360>"
}