Data-Driven Alarm Management Solutions
Clinical alarm management is a safety initiative for healthcare providers. The Joint Commission has created the National Patient Safety Goal on Alarm Management, NPSG,06.0101, making it more crucial than ever to address this challenge.
GE Healthcare is working with healthcare providers to develop effective alarm management strategies and tools that incorporate sophisticated technology, best practices and consulting to help reduce alarm fatigue, improve workflow, and support a healing environment for patients and their families.
Leveraging technology to enhance patient outcomes
Today's critical care environments rely heavily on technology to continually enhance patient care and help keep them safe. Accurate, comprehensive monitoring data and algorithms are critical elements of the comprehensive GE Healthcare data-driven Alarm Management solution.
Our solution has been thoughtfully engineered to include advanced algorithms and technologies to enable caregivers to deliver focused patient care including:
- EK-Pro* Simultaneous Multi-lead Arrhythmia Detection
- DINAMAP SuperStat Non-invasive Blood Pressure
- Pulse Oximetry
1. EK-Pro* Simultaneous Multi-lead Arrhythmia Detection
One important technology advancement from GE Healthcare is multi-lead monitoring for arrhythmia. Technologies that analyze only one or two leads fail to meet an American Heart Association recommendation that "monitors should be capable of simultaneously displaying and analyzing two and preferably three or more leads." 1
EK-Pro arrhythmia analysis algorithm from GE Healthcare provides simultaneous multi-lead ECG arrhythmia analysis and monitoring for adult, pediatric and neonatal patients. EK-Pro simultaneously analyzes four leads of ECG (I, II, III, and V).
The benefits of multi-lead monitoring include:
- Enhanced rejection of artifact caused by patient movement and muscle artifact.
- Reduction of false calls due to Low QRS amplitude.
- Assurance of uninterrupted monitoring, even in case of an electrode contact failure (Smart Lead Fail).
The picture below highlights the benefits of using three or more leads for arrhythmia detection. The monitor correctly identified 1 PVC in spite of the noticeable artifact. Lead III remains stable, allowing the algorithm to continue possessing in spite of the baseline noise and artifact caused by patient movement.
IntelliRate is a multi-parameter algorithm that analyzes information from multiple parameters: ECG, arterial blood pressure and/or pulse oximetry. The algorithm enhances ECG measurement accuracy and helps to reduce the number of false positive alarms.
3. DINAMAP SuperStat Non-invasive Blood Pressure
GE Healthcare's patient monitors use the DINAMAP* oscillometric non-invasive blood pressure (NIBP) technology. This technology is an indirect measure of cuff pressure oscillations that are caused by the changes in arterial volume during cuff deflation. The DINAMAP algorithm utilizes a step deflation process and requires at least two matching oscillations per step deflation to determine mean arterial blood pressure, systolic and diastolic blood pressure values.
4. Pulse Oximetry
Bedside monitors from GE contain either Masimo Signal Extraction Technology** (SET) or Nellcor OxiMax** pulse oximetry algorithms. Both use advanced digital signal processing technologies to deliver accurate SPO2 and pulse rate readings, despite patient motion and low perfusion.
1. Mirvis, D.M., et al. "Instrumentation and practice standards for electrocardiographic monitoring in special care units. A report for health professionals by a Task Force of the Council on Clinical Cardiology." American Heart Association 79, 464-471 (February 1989).
Smart Leads. Smart Alarms. Smarter Workflow.
Alarms are a challenge in today's hospitals. Caregivers endure an enormous number of alarms, beeps and chimes which can be disruptive -leading to alarm fatigue, patient dissatisfaction and stress for family members. GE Healthcare is committed to working with clinicians to deliver timely critical patient information while supporting efforts to enhance and improve workflow.
ECRI Institute has identified alarm hazards as the number one issue in its Top 10 Technology Hazards for 2015. Strategies for reducing alarm hazards often focus on alarm fatigue, but this is not the only factor that should be considered when working towards improving clinical alarm managements. Alarm-related adverse events are often traced to inappropriate alarm configurations and practices. Inappropriate alarm configuration practices can lead to caregivers not being notified of a valid alarm condition, or caregivers being exposed to an excessive number of alarms.1
GE Healthcare's advanced monitoring solutions include technologies to address the alarm management challenges and offer the potential to reduce alarm fatigue, provide insights into appropriate alarm configuration practices, enhance workflow and deliver a peaceful and healing environment for patients and staff. Our solutions have thoughtfully engineered to include the ability to adjust parameter settings to match the individual needs of the patients and have integrated to technology to ensure uninterrupted monitoring including:
- Smart Lead Fail - providing uninterrupted arrhythmia monitoring in the event of a disconnected lead.
- Telemetry Smart Alarms - helping to ensure uninterrupted monitoring.
- User-Configurable Alarm Priority Setting2 - allowing caregivers to tailor parameter and arrhythmia alarm priorities based on patient's intrinsic rhythm and/or parameter value.
- Absolute Limits - prevents clinicians from adjusting parameter limits above and below what is considered a reasonable and safe range.
- Locking Alarms - prevent clinicians from turning a parameter limit alarm off.
1. Smart Lead Fail
Smart Lead Fail provides uninterrupted arrhythmia monitoring in the event of a disconnected lead. Patients remain monitored until a nurse can restore the lead connection.
Once the lead is reconnected, monitoring continues without the relearning process. In less sophisticated monitoring systems, the patient is unmonitored while the system relearns the heart rhythm. Those delays can be hazardous to patients with life-threatening arrhythmias.
The picture below highlights the benefits of Smart Lead Fail. Having lost both the RA and V leads, monitoring continues without initiating a lengthy learning process. Arrhythmia processing is maintained until the clinician can reattach both leads.
2. Telemetry Smart Alarms
When telemetry packs are removed for bathing or tests that require patients to leave the floor, pausing and or reactivating alarms is often forgotten.
With Telemetry Smart Alarms, alarms will automatically reactivate when the patient is within range of the antenna system for 15 seconds or longer, and continuous ECG data is detected. If the patients remains out of antenna range, the alarm pause state will continue until the patient re-enters antenna range for the 15-second threshold.
3. User-Configurable Alarm Priority Setting2
User-configurable alarm priorities allow clinicians to tailor parameter and arrhythmia alarm priorities based on your patient's intrinsic rhythm and/or parameter value.
Case Report: A 69-year-old patient is admitted for elective surgery. The patient has a five-year history of controlled atrial fibrillation. While clinicians will continue to monitor the patient's rate, they can adjust the arrhythmia alarm priority from medium or low to informational. An informational alarm priority provides a visual alert without an audible alarm.
4. Absolute Limits
Absolute guard limits prevent clinicians from adjusting parameter limits above and below what is considered a reasonable and safe range. Absolute limits are configured by the system administrator and are password protected.
5. Locking Alarms
Locking alarms prevent clinicians from turning a parameter limit alarm off. An icon is placed next to the alarm setting indicating the alarm is locked. Locking alarms are configured by the system administrator and are password protected.
2. Alarm changes are based on unit/facility alarm guidelines.
GE Healthcare's advanced alarm notification technology lets you create more productive workflows and helps you improve the quality of care.
Primary Alarm Notification Solutions
1. Auto View on Alarm
Auto View on Alarm provides an automatic notification when a remote patient goes into distress. The patient in alarm will be displayed in split screen via the local bed.
2. CARESCAPE* Central Station
The CARESCAPE Central Station unites clinical intelligence across the enterprise, integrating real-time and historical data from multiple monitoring sources and presenting it to caregivers in the context of their workflow.
- The viewing station offers real-time waveforms and vital information for any patient connected to the CARESCAPE Network.
- The monitoring station permits clinicians to admit, discharge and manage patient alarms.
Find out more about the CARESCAPE Central Station.
Secondary Alarm Notification Solutions
1. Ascom Secondary Alarm Notification
Get a text-based alarm notification, including bed location, severity and status, along with up to a 12-second waveform snapshot for ECG-related events, to help you better understand and react to a given clinical situation.
- Ascom Unite Axess for smart devices expands the mobility of patient data distribution in near real time to devices such as iPhones**, iPads**, and Android** smartphones.
- Ascom Mobile Monitoring Gateway (MMG) allows filtering and prioritization to enhance alarm management and help avoid alarm fatigue.
Find out more about Ascom Secondary Alarm Notifications.
2. Airstrip PATIENT MONITORING
GE Healthcare's exclusive AirStrip PATIENT MONITORING* allows you to access critical clinical information, including near-real-time and historical waveform data previously accessible only at the patient's bedside, securely and natively via Apple** iPad** and iPhone** devices.
Combined with the CARESCAPE Gateway from GE Healthcare, AirStrip PATIENT MONITORING allows clinicians to scroll through the most recent 24 hours of near-real-time waveform data as it is displayed at the bedside, with full detail and sharp resolution.
Find out more about Airstrip Patient Monitoring.
3. CARESCAPE Mobile Viewer - Web Viewer
CARESCAPE Mobile Viewer - Web Viewer allows you to quickly check the status of your patients directly from your PC, Mac** or tablet PC without making a trip to the bedside or even the hospital. Multi-patient view capability supports viewing multiple patients simultaneously and provides a means for remote monitoring and consultation of any patient connected to a variety of GE Healthcare acquisition devices.
Web Viewer enables up-to-the-moment access by visually displaying active alarms for a prompt view of your patient's status and helps you stay connected to your patients by providing a detailed view of near-real-time waveforms, vital signs, and graphic trends with a user-configurable patient list.
Find out more about CARESCAPE Mobile Viewer.
Alarm Reporting Tool
What you can measure, you can manage.
The Alarm Reporting Tool (ART) delivers data that helps you make educated choices on how to manage GE bedside monitor and telemetry alarms. This simple software tool allows you to easily compile an alarm history looking back up to 60 days. Concise, customizable reports help you spot trouble areas, identify possible opportunities, and measure and sustain improvements. You can generate reports on:
- Arrhythmia alarms
- Parameter alarms for heart and respiratory rate, SpO2, blood pressure and more
- Technical alarms for events such as ECG lead detachment and sensor failure
- Detailed listing of alarm events for a single patient monitor
Clear data. Clear benefits.
Data from the ART can guide you to improvements that significantly enhance your care environments, leading you towards quieter care environments. ART can help you with:
- Making informed decisions on setting alarm protocols and parameter limits
- Reducing audio alarm burdens on patients and staff
- Modifying alarm priorities to make alarms more actionable
- Reducing technical alarms with better lead preparation and lead replacement policies
Along with the purchase of the Alarm Reporting Tool, we offer two consulting services options where our clinical experts can help you work towards your goal of quieter environments. The options include
- Remote consultation
- Provides guidance in reviewing the reports and identifying areas of improvement
- Shares best practices
- Includes a single follow-up session to review results of customer-implemented interventions
- Onsite alarm consulting services
- Provides guidance in a four-step self-improvement process
- Provides guidance in reviewing the reports and identifying areas of improvement
- Provides education on alarm management and guidance in selecting optimum alarm default settings for your GE monitoring devices
- Provides training in additional clinical practices, such as proper skin preparation and lead placement, that may help reduce false alarms