NR 361 Week 6 Graded Discussion Topic, Distractors in our Environment

Distractions are everywhere. They may include cellphones, the alarms sounding for multiple different reasons, overhead paging, monitors beeping, and staff interrupting our thoughts. Give an example of an ethical or legal issue that may arise if a patient has a poor outcome or sentinel event because of a distraction such as alarm fatigue. What does evidence reveal about alarm fatigue and distraction when it comes to patient safety?

As a nurse, you have many responsibilities. Nurses are multitaskers they monitor the patients, medications, equipment, and much more while documenting everything that has been done.   “Most technologies are designed by people unfamiliar with nurses’ workflow, and they fail to appreciate the multitude of other devices the nurse is simultaneously managing” (Ruppel & Funk, 2018). Therefore, due to these designers not understanding what a nurse’s role is the technology that we use does not always fit well with the nursing roles. Multitasking is overwhelming and nursing is a hard job in general adding the two can cause errors. Bed alarms are designed to alarm when the patient is moving off the bed. The alarm can also go off when the patient makes certain movements not just moving off the bed.  For example, a nurse working a unit with several patients. One of the patients has a bed alarm and tends to make it go off on purpose multiples times. When the nurse arrives, the patient asks her about her day but does not need assistance. At the end of the night the nurse is busy when that patients bed alarm goes off, but the nurse ignores it because of what she experienced all day. “This alarm fatigue is compounded by the number of potential false alarms during a nurses’ work shift” (Hebda, Hunter, & Czar, 2019). The patient had called the nurse to ask for assistance to the bathroom. When the nurse did not respond the patient went alone and fell on the way and broke his leg. This is an ethical because there was a poor patient outcome due to unknown distraction and continuous false alarms. One of the nursing ethical guiding principles is “nonmaleficence: the obligation for doing no intentional harm” (Hebda, Hunter, & Czar, 2019).  The nurse did not do intentional harm but cause harm due to the intentional disregard of the bed alarm.

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NR 361 Week 6 Graded Discussion Topic, Distractors in our Environment

“Alarms are by intent interruptive. Interruptions are typically considered to have a negative effect on patient safety. However, interruptions have been associated with an increased risk of errors” (Ruppel & Funk, 2018). The evidence shows that alarms are used to help patients, but they are a risk for negative patient safety. There is still need for research on how to join the two worlds where they can work together. One way is the lessen the nurses workload so that she does not feel overwhelmed to the point where they ignore their patients.

References

Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of informatics for nurses & healthcare professionals (6th ed.). Pearson.

Ruppel, H., & Funk, M. (2018). Nurse–Technology Interactions and Patient Safety. Critical Care Nursing Clinics of North America, 30(2), 203-213. doi:10.1016/j.cnc.2018.02.003

Nursing workflow is unique and it is very important that we have an input on any design that will impact our job’s workflow. A basic example we experienced at my hospital is when one of our telemetry units was remodeled and the nurses were not asked for any input. The flow of the nurse’s station was so dysfunctional, it was set up like a classroom. The computers were set up in rows so close together that it made it virtually impossible to respond quickly to alarms or any urgent situation for that matter. We had to practically climb over one another. This added to a decrease in response time to alarms which was an increase for patient risk of injury. It was a costly mistake and the unit was redesigned. Now the trend is to consult the individual unit to better understand the needs of the particular specialty in regards to its workflow. Luckily there was a lot of nursing input considered when my facility chose to go with a new operating system. We chose Epic.

Bed alarm fatigue is also an issue at my workplace. One thing that helps, aside from making sure staff is deactivating the alarm prior to getting patients up, is the alarm sensitivity buttons. Our bed alarm sensitivity can be adjusted based on weight or increased risk. I can appreciate your suggestion of a decreased ratio however, I don’t believe I will experience that anytime soon.