Date of Award

8-2015

Document Type

Thesis

Degree Name

Master of Science (MS)

Legacy Department

Industrial Engineering

Advisor

Neyens, David M

Committee Member

Cho, Byung R

Committee Member

Riggs, Sara L

Abstract

Clinical alarms have become an indispensable part of medical environment, but issues related to alarm artifacts, false alarms, and alarm fatigue have been identified. A national online survey administered to hospitals stated healthcare workers determined that 81% of respondents agreed that alarms occur frequently, 77% agreed that excessive clinical alarms disrupt patient care, and 78% agreed that reduced trust in alarms cause caregivers to disable them (Korniewicz, Clark, & David, 2008). Studies have suggested that preparation of skin of the patient improves electrode-skin contact, thereby resulting in fewer artifacts (Hermens, Freriks, Disselhorst-Klug, & Rau, 2000). Additionally, clinical studies have shown that the electrode-skin interface is frequently overlooked as a major source of artifact affecting many electro-physiologic recordings (Oster, 1998). The purpose of the thesis is to evaluate how the implementation of procedural changes, specifically implementing a patient's chest preparation procedure prior to electrode placement influences the rate of clinical alarms, (i.e., critical or warning cardiac alarms) in an intensive care unit (ICU). Data from clinical alarms were collected from a regional hospital in South Carolina. The data contained the number of clinical alarms recorded with and without nurse administered chest preparation. Functional data analysis was used to evaluate if chest preparation procedure had a significant impact on the rate of clinical alarms produced over an 8-hour shift. The results suggest that there is no significant reduction in the alarm frequency after the implementation of nurse administered chest preparation. However, a nominal decrease in the number of alarms per hour per patient and some preliminary trends were observed during the data analysis that warrants the need for future research in this direction.

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Engineering Commons

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