A Call for Help: Hourly Rounding to Reduce Alarm Fatigue
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Abstract
BACKGROUND/LOCAL PROBLEM: Frequent call lights and alarm fatigue were identified by
nursing staff and leadership as a quality concern on a Heart Vascular Unit in the mid-Atlantic
region. Alarm fatigue negatively effects safety and patient and nurse satisfaction. Structured
hourly rounds can reduce patient call lights. The purpose of this DNP project was to implement
and evaluate the effectiveness of nurse hourly rounding on call light frequency on a 30-bed
inpatient Heart Vascular Unit.
METHODS: This was a quality improvement project with pre- and post-implementation
assessments on alarm fatigue and call light quantity. The nursing staff was measured with a self
reporting instrument. Call light quantity was measured through alarm reports. Paper tracking
forms audited staff adherence.
INTERVENTIONS: Hourly nurse rounding was implemented over 14 weeks. Staff were trained
in teaching sessions. Each hour a member of the nursing staff entered the patient’s room and
assessed their needs. Rounds were recorded on the tracking forms.
RESULTS: The clinical outcomes were number of call lights that occurred in a 24-hour period.
There was no significant change between pre- and post-implementation measures. The
perceptual outcome was alarm fatigue in bedside nursing staff; improvement was seen in the
majority of assessment responses.
CONCLUSION: Structured nurse hourly rounding reduced the perceived and measured alarm
fatigue among bedside staff. No significant difference was seen in the quantity of call lights.
Hourly rounding may reduce alarm fatigue and improve patient and nursing satisfaction.