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 数字解决方案

分布式报警系统。 在安静的 ICU

护士由于报警捂住双耳

斗争是真实的。 ICU 里的报警疲劳

每个 ICU 病人的平均报警次数可超过每天 700 次。预计 80% 至 95% 上述报警在临床上不重要 (Cvach M. Monitor alarm fatigue: an integrative review.Biomed Instrum Technol.2012;46(4):268-277. doi:10.2345/0899-8205-46.4.2681​, McBride DL, LeVasseur SA.Personal Communication Device Use by Nurses Providing In-Patient Care: Survey of Prevalence, Patterns, and Distraction Potential.JMIR Hum Factors.2017;4(2):e10.Published 2017 Apr 13. doi:10.2196/humanfactors.51102​)。

处理这么多无需干预的报警可能导致护理人员报警疲劳 (https://www.ecri.org/Resources/In_the_News/Sound_the_Alarm(PSQH).pdfA​)。这会增加病人伤害以及病人和医务人员不满意的风险 (https://www.ecri.org/Resources/In_the_News/Sound_the_Alarm(PSQH).pdfA​, https://www.ncbi.nlm.nih.gov/books/NBK555522/B​)。

图:正在通气的病人。报警显示在护士站。

音频关闭! 静音

当配置为分布式报警系统 (DAS) 的一个组成部分时 (Only available for HAMILTON-C6/G5/S1C​),呼吸机的声音报警可以暂停无限时间。此功能被称为全部音频关闭。

全部音频关闭启用时,将呼吸机报警传输至 DAS 中的其他设备,同时呼吸机上的可视报警指示灯保持激活状态。

HAMILTON-C6_ASCOM-Silent-ICU_youtube

Peace of mind. Alarm management with Ascom

The combination of the Ascom Digistat 7.2 with the HAMILTON‑C6 and HAMILTON‑G5/S1 ventilators provides a DAS-compliant system. The Ascom alarm management system receives full delegation of all alarms from the HAMILTON‑G5/S1 and HAMILTON‑C6 ventilators, ensuring completely reliable alarm management.

Alarm notifications can be sent to caregivers' mobile phones, or displayed on desktops or dashboards.

可用性

分布式报警系统集成可作为 HAMILTON-C6 和 HAMILTON-G5/S1 呼吸机的一个选配件提供。

Monitor alarm fatigue: an integrative review.

Cvach M. Monitor alarm fatigue: an integrative review. Biomed Instrum Technol. 2012;46(4):268-277. doi:10.2345/0899-8205-46.4.268

Alarm fatigue is a national problem and the number one medical device technology hazard in 2012. The problem of alarm desensitization is multifaceted and related to a high false alarm rate, poor positive predictive value, lack of alarm standardization, and the number of alarming medical devices in hospitals today. This integrative review synthesizes research and non-research findings published between 1/1/2000 and 10/1/2011 using The Johns Hopkins Nursing Evidence-Based Practice model. Seventy-two articles were included. Research evidence was organized into five main themes: excessive alarms and effects on staff; nurse's response to alarms; alarm sounds and audibility; technology to reduce false alarms; and alarm notification systems. Non-research evidence was divided into two main themes: strategies to reduce alarm desensitization, and alarm priority and notification systems. Evidence-based practice recommendations and gaps in research are summarized.

Personal Communication Device Use by Nurses Providing In-Patient Care: Survey of Prevalence, Patterns, and Distraction Potential.

McBride DL, LeVasseur SA. Personal Communication Device Use by Nurses Providing In-Patient Care: Survey of Prevalence, Patterns, and Distraction Potential. JMIR Hum Factors. 2017;4(2):e10. Published 2017 Apr 13. doi:10.2196/humanfactors.5110



BACKGROUND

Coincident with the proliferation of employer-provided mobile communication devices, personal communication devices, including basic and enhanced mobile phones (smartphones) and tablet computers that are owned by the user, have become ubiquitous among registered nurses working in hospitals. While there are numerous benefits of personal communication device use by nurses at work, little is known about the impact of these devices on in-patient care.

OBJECTIVE

Our aim was to examine how hospital-registered nurses use their personal communication devices while doing both work-related and non‒work-related activities and to assess the impact of these devices on in-patient care.

METHODS

A previously validated survey was emailed to 14,797 members of two national nursing organizations. Participants were asked about personal communication device use and their opinions about the impact of these devices on their own and their colleagues' work.

RESULTS

Of the 1268 respondents (8.57% response rate), only 5.65% (70/1237) never used their personal communication device at work (excluding lunch and breaks). Respondents self-reported using their personal communication devices at work for work-related activities including checking or sending text messages or emails to health care team members (29.02%, 363/1251), as a calculator (25.34%, 316/1247), and to access work-related medical information (20.13%, 251/1247). Fewer nurses reported using their devices for non‒work-related activities including checking or sending text messages or emails to friends and family (18.75%, 235/1253), shopping (5.14%, 64/1244), or playing games (2.73%, 34/1249). A minority of respondents believe that their personal device use at work had a positive effect on their work including reducing stress (29.88%, 369/1235), benefiting patient care (28.74%, 357/1242), improving coordination of patient care among the health care team (25.34%, 315/1243), or increasing unit teamwork (17.70%, 220/1243). A majority (69.06%, 848/1228) of respondents believe that on average personal communication devices have a more negative than positive impact on patient care and 39.07% (481/1231) reported that personal communication devices were always or often a distraction while working. Respondents acknowledged their own device use negatively affected their work performance (7.56%, 94/1243), or caused them to miss important clinical information (3.83%, 47/1225) or make a medical error (0.90%, 11/1218). Respondents reported witnessing another nurse's use of devices negatively affect their work performance (69.41%, 860/1239), or cause them to miss important clinical information (30.61%, 378/1235) or make a medical error (12.51%, 155/1239). Younger respondents reported greater device use while at work than older respondents and generally had more positive opinions about the impact of personal communication devices on their work.

CONCLUSIONS

The majority of registered nurses believe that the use of personal communication devices on hospital units raises significant safety issues. The high rate of respondents who saw colleagues distracted by their devices compared to the rate who acknowledged their own distraction may be an indication that nurses are unaware of their own attention deficits while using their devices. There were clear generational differences in personal communication device use at work and opinions about the impact of these devices on patient care. Professional codes of conduct for personal communication device use by hospital nurses need to be developed that maximize the benefits of personal communication device use, while reducing the potential for distraction and adverse outcomes.