1998 OPEN FORUM Abstracts
IMPROVED RESPONSE TO VENTILATOR ALARMS IN A SUBACUTE NURSING FACILITY.
John Emberger BS RRT, Phil Santoro BS RRT, Cathy Hart RRT, Sue Redden-Bailey RRT Department of Respiratory Care, Christiana Care Health System, Newark DE.
Background: In a subacute ventilator facility, there are many reasons respiratory and nursing staff may not respond to ventilator alarms within an appropriate time. Some reasons may include; less staff to patient ratio than in an acute care facility, alarm desensitization of the staff and greater distance over which alarms must be heard. We could find no standard in the literature for appropriate time to respond to alarms. We gathered baseline ventilator alarm time data (see Initial Data chart) which showed intolerable time periods of ventilators alarming with no response of staff. Hypothesis: We wanted to improve the performance of staff response time to ventilator alarms at our subacute nursing facility. Methods: At our sub-acute nursing facility, a printer connected to the Puritan Bennett 7200 ventilators collected data. Printers recorded duration of the active ventilator alarms. Baseline data was collected (for 2 weeks), then an interdisciplinary performance improvement process took place (two month implementation). Follow-up data was then collected (for 2 weeks). The performance improvement process included: 1) ventilators were all placed in the same unit, 2) agency nurses no longer cared for ventilator patients, 3) less rotation of nursing staff, 4) nurses spent time in the acute-care weaning unit to learn the importance of responding to alarms, 5) improved respiratory and nursing communication concerning who will respond at any given time, 6) respiratory and nursing staff coordinated coverage during shift report 7) nurses were aware when respiratory staff was not in the unit. Results: See the charts for the Initial Data and Follow-up Data. Average ventilator alarm time of the Initial Data = 4.05 minutes, and the average of the Follow-up Data = 1.45 minutes. Discussion: The interdisciplinary performance improvement dramatically decreased the average time to respond to ventilator alarms, and increased awareness of responding appropriately to ventilator alarms. After the improvement (in the Follow-up Data) there were no occurrences longer than five minutes, whereas in the Initial Data there were multiple alarms lasting six minutes or greater.
(See Original for Figure)
The 44th International Respiratory Congress Abstracts-On-Disk®, November 7 - 10, 1998, Atlanta, Georgia.