Attitudes and Practices Related to Clinical Alarms: A Follow-up Survey.

Background: Alarm fatigue is a widely acknowledged patient safety concern in hospitals. In 2013, The Joint Commission issued a National Patient Safety Goal on Alarm Management, making addressing alarm management a priority. To capture changes in attitudes and practices related to alarms, the Healthcare Technology Foundation conducted and reported findings from national online surveys in 2006 and 2011 and completed a third survey in 2016.

Attitudes and practices related to clinical alarms.

Background: The number of devices with alarms has multiplied in recent years, causing alarm fatigue in bedside clinicians. Alarm fatigue is now recognized as a critical safety issue.

Objective: To determine if attitudes and practices related to clinical alarms have changed since 2005.

Reducing hospital noise: a review of medical device alarm management.

Increasing noise in hospital environments, especially in intensive care units (ICUs) and operating rooms (ORs), has created a formidable challenge for both patients and hospital staff. A major contributing factor for the increasing noise levels in these environments is the number of false alarms generated by medical devices. This study focuses on discovering best practices for reducing the number of false clinical alarms in order to increase patient safety and provide a quiet environment for both work and healing.

A fast stir bar sorptive extraction method for the analysis of geosmin and 2-methylisoborneol in source and drinking water.

The presence of unpleasant taste and odour in drinking water is an ongoing aesthetic concern for water providers worldwide. The need for a sensitive and robust method capable of analysis in both natural and treated waters is essential for early detection of taste and odour events. The purpose of this study was to develop and optimise a fast stir bar sorptive extraction (SBSE) method for the analysis of geosmin and 2-methylisoborneol (MIB) in both natural water and drinking water.

The definition of a clinical engineer.

The American College of Clinical Engineering formed a committee to develop a contemporary definition of a Clinical Engineer. The committee considered existing definitions including that currently used by the Clinical Engineering Board of Examiners of the International Certification Commission. Educators and other societies provided other definitions.

Failure of electrocardiographic monitoring to detect cardiac arrest in patients with pacemakers.

Two children with cardiac pacemakers are described who experienced cardiorespiratory arrest not detected by the electrocardiographic (ECG) monitor. The pacemaker stimuli were interpreted by the monitor as a QRS complex with inhibition of the heart rate alarm, demonstrating the need for reliable non-ECG monitoring in patients with pacemakers. A review of all deaths in children with pacemakers in the last ten years also shows the high association of respiratory failure in patients with congenital heart disease and a pacemaker, underscoring this need.

Productivity: standard terminology and definitions.

There exists a need for a standard set of definitions to describe and measure the tasks performed by the staffs of clinical engineering departments. Too often, in discussions and publications on productivity, inconsistencies exist that make comparisons difficult between the author's methodology and that used by readers or other authors. To avoid this, there needs to be uniformity in the classification of which tasks are productive and the way those tasks are documented, tabulated, and reported.

Noninvasive external recording of cardiac conduction system (His bundle) activity.

Successful and adequate external recording of the cardiac conduction system from the body's surface can be accomplished in 80 to 90 percent of subjects studied. High-gain amplification, signal averaging, and triggering with a conditioned QRS signal results in good recording reproducibility. Averaging of 128 consecutive cycles is adequate, but on occasion averaging of 256 cycles may yield better results.

Noninvasive recording of His-Purkinje activity in man by ORS-triggered signal averaging.

Mobile instrumentation and a clinically applicable method have been developed for external His bundle recording. High gain signal amplification (10)(5) filtering (30--300 HZ) and averaging (128 or 256 consecutive cycles) are used. Acquisition of signals arising in the P-R interval is triggered by the patient's QRS signal at the end of that interval.