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Institute for Johns Hopkins Nursing

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Alarm Management

JHH Monitor Experts

Although alarms are important and sometimes life-saving, they can compromise patients' safety if ignored. 

The most referenced research for reducing false alarms and increasing the number of actionable alarms is that of Maria Cvach, RN, MSN, CCRN and her colleague Kelly Creighton Graham, RN, BS. “Monitor Alarm Fatigue: Standardizing Use of Physiological Monitoring and Decreasing Nuisance Alarms”.

In 2006, these clinical nurse experts at the Johns Hopkins Hospital began an effort to improve patient safety related to bedside alarm management. Based on best evidence, unit guidelines and recommendations were developed. This unit-based quality improvement initiative was beneficial as a starting point for revamping alarm management throughout the institution.  

Since the alarm improvement efforts began in 2006, The Johns Hopkins Hospital has seen:

  • A drop in total number of monitor alarm conditions and signals from monitors hospital-wide.
  • 43 percent reduction in high priority alarm conditions during an 18 day period – 16, 952 to 9,647 alarm conditions on a medical progressive care unit.
  • 24 to 74 percent reduction of alarm conditions on six ICU and IMC units analyzed pre and post default parameter change.
  • 47 percent reduction in total alarm conditions per bed per day on two pilot units performing daily electrode change.
  • Decrease in amount and duration of lead-fail and arrhythmia-suspend alarm conditions using disposable leads.

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