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A critical assessment of monitoring practices, patient deterioration, and alarm fatigue on inpatient wards: a review.

Curry JP, Jungquist CR - Patient Saf Surg (2014)

Bottom Line: Leading up to this Century, it was common for most hospitalized patients and their families to believe that being surrounded by well-trained nurses and physicians assured their safety.We have designed our physiologic explanations and simplified cognitive framework to give our front line clinical nurses a thorough, easy-to-recall understanding of just how these events evolve, and how to detect them early when most amenable to treatment.Our review will also discuss currently available practices in general care floor monitoring that can both improve patient safety and significantly reduce monitor associated alarm fatigue.

View Article: PubMed Central - HTML - PubMed

Affiliation: UCLA Department of Anesthesiology, Hoag Memorial Hospital Presbyterian, One Hoag Drive, 92663 Newport Beach, CA, USA.

ABSTRACT
Approximately forty million surgeries take place annually in the United States, many of them requiring overnight or lengthier post operative stays in the over five thousand hospitals that comprise our acute healthcare system. Leading up to this Century, it was common for most hospitalized patients and their families to believe that being surrounded by well-trained nurses and physicians assured their safety. That bubble burst with the Institute of Medicine's 1999 report: To Err Is Human, followed closely by its 2001 report: Crossing the Quality Chasm. This review article discusses unexpected, potentially lethal respiratory complications known for being difficult to detect early, especially in postoperative patients recovering on hospital general care floors (GCF). We have designed our physiologic explanations and simplified cognitive framework to give our front line clinical nurses a thorough, easy-to-recall understanding of just how these events evolve, and how to detect them early when most amenable to treatment. Our review will also discuss currently available practices in general care floor monitoring that can both improve patient safety and significantly reduce monitor associated alarm fatigue.

No MeSH data available.


Related in: MedlinePlus

RECC type III pattern of respiratory dysfunction with arousalfailure, recoveries, and alarm fatigue markers.
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Figure 5: RECC type III pattern of respiratory dysfunction with arousalfailure, recoveries, and alarm fatigue markers.

Mentions: These Type III apnea patterns are comprised of repetitive reductions in airflowand SPO2 from sleep related cycling collapses of the upper airway [65,66]. This cycling (shown in Figure 5 below)with initial collapsing and then reopening of the upper airway, produces atypical, very distinct pattern of signal clusters that is reliably acquiredthrough high resolution pulse oximetry (Note the potential for alarm fatigue ifalarm threshold values are set near 90% SPO2). Interventionsinvolving pressure support, e.g., CPAP and BiPAP, can diminish or completelyresolve this Type III pattern as they do when used to treat RECC Type II‘substitution’ patterns and their associated risks.


A critical assessment of monitoring practices, patient deterioration, and alarm fatigue on inpatient wards: a review.

Curry JP, Jungquist CR - Patient Saf Surg (2014)

RECC type III pattern of respiratory dysfunction with arousalfailure, recoveries, and alarm fatigue markers.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4109792&req=5

Figure 5: RECC type III pattern of respiratory dysfunction with arousalfailure, recoveries, and alarm fatigue markers.
Mentions: These Type III apnea patterns are comprised of repetitive reductions in airflowand SPO2 from sleep related cycling collapses of the upper airway [65,66]. This cycling (shown in Figure 5 below)with initial collapsing and then reopening of the upper airway, produces atypical, very distinct pattern of signal clusters that is reliably acquiredthrough high resolution pulse oximetry (Note the potential for alarm fatigue ifalarm threshold values are set near 90% SPO2). Interventionsinvolving pressure support, e.g., CPAP and BiPAP, can diminish or completelyresolve this Type III pattern as they do when used to treat RECC Type II‘substitution’ patterns and their associated risks.

Bottom Line: Leading up to this Century, it was common for most hospitalized patients and their families to believe that being surrounded by well-trained nurses and physicians assured their safety.We have designed our physiologic explanations and simplified cognitive framework to give our front line clinical nurses a thorough, easy-to-recall understanding of just how these events evolve, and how to detect them early when most amenable to treatment.Our review will also discuss currently available practices in general care floor monitoring that can both improve patient safety and significantly reduce monitor associated alarm fatigue.

View Article: PubMed Central - HTML - PubMed

Affiliation: UCLA Department of Anesthesiology, Hoag Memorial Hospital Presbyterian, One Hoag Drive, 92663 Newport Beach, CA, USA.

ABSTRACT
Approximately forty million surgeries take place annually in the United States, many of them requiring overnight or lengthier post operative stays in the over five thousand hospitals that comprise our acute healthcare system. Leading up to this Century, it was common for most hospitalized patients and their families to believe that being surrounded by well-trained nurses and physicians assured their safety. That bubble burst with the Institute of Medicine's 1999 report: To Err Is Human, followed closely by its 2001 report: Crossing the Quality Chasm. This review article discusses unexpected, potentially lethal respiratory complications known for being difficult to detect early, especially in postoperative patients recovering on hospital general care floors (GCF). We have designed our physiologic explanations and simplified cognitive framework to give our front line clinical nurses a thorough, easy-to-recall understanding of just how these events evolve, and how to detect them early when most amenable to treatment. Our review will also discuss currently available practices in general care floor monitoring that can both improve patient safety and significantly reduce monitor associated alarm fatigue.

No MeSH data available.


Related in: MedlinePlus