A Call for Help: Hourly Rounding to Reduce Alarm Fatigue

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.