Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2016 Development of a Policy and Procedure to Decrease Alarm Fatigue Samantha Deck Walden University Follow this and additional works at:https://scholarworks.waldenu.edu/dissertations Part of theNursing Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please [email protected]. Walden University College of Health Sciences This is to certify that the doctoral study by Samantha Deck has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Joan Moon, Committee Chairperson, Health Services Faculty Dr. Connie Vogel, Committee Member, Health Services Faculty Dr. Cassandra Taylor, University Reviewer, Health Services Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2016 Abstract Development of a Policy and Procedure to Decrease Alarm Fatigue by Samantha K. Deck MS, Indiana State University, 2010 BS, Indiana Wesleyan, 2008 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University June 2016 Abstract According to The Joint Commission (TJC), 98 unexpected and unacceptable events related to alarm fatigue were reported in United States hospitals between January 2009 and June 2012. There were 80 deaths, 13 permanent loss of function, and 5 extended care stays that occurred during this time period. The problem identified in this quality improvement (QI) initiative was the TJC report that nursing staff in the US was experiencing alarm fatigue due to the overstimulation of senses from continuous beeping from alarms on the unit. Framed within the Iowa model of evidence-based practice to promote quality care, the purpose of the project was to develop a patient care alarm fatigue initiative as mandated by TJC including a policy and procedure for managing alarm fatigue, a curriculum plan for educating the nursing staff on alarm fatigue, and a survey on nurse attitudes toward alarm fatigue to be administered at the beginning of the education. The developed policy and procedure was approved by the committee with the recommendation to revise the policy to involve all ancillary staff in direct contact with clinical alarms. The curriculum objectives were evaluated by 2 content experts using a 4 item met/not met response format. Findings showed that all objectives were met. The content of the nurse survey was reviewed by the experts using a 3 item Likert scale and all the items were deemed relevant. Finally, team members (n = 9) completed a summative evaluation of the project using an 8 item, 5-option Likert scale. All were in agreement that the project met its intent. The implementation of this project after graduation has the potential to bring about social change by increasing patient safety, patient wellbeing and reducing healthcare costs. Development of a Policy and Procedure To Decrease Alarm Fatigue by Samantha K. Deck MS, Indiana State University, 2010 BS, Indiana Wesleyan University, 2008 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University June 2016 Dedication The dedication of my work is dedicated to my husband and children, who have been a consistent source of caring support and encouragement throughout the challenges of graduate school. I would also like to dedicate my work in memory of my deceased father, my parents Joseph and Young Hui Mentel, my siblings Subrina, Travis, and Kevin who have always been there for me throughout my tribulations in life. Everyone one of you have been an inspiration to me and continue to inspire me to become a leader in healthcare through academia and clinical practice. Acknowledgments I would like to thank my committee members for their continued support and encouragement: Dr. Joan Moon, my committee chair; Dr. Connie Vogel, member; Dr. Cassandra Taylor, University Researcher Reviewer. I would like to offer my sincere appreciation for the continued support and great advice to my first preceptor Dr. Lisa Goins, without your guidance I could have not accomplished the completion of my project. I would also like to thank my mentor Patricia Adkins, MSN, RN, CNP for the completion of my project for the opportunity to finish my DNP project, guidance throughout my project, and most of the opportunity to gain the leadership skills that I have gained through the process of my DNP project. Table of Contents List of Tables .......................................................................................................................v List of Figures .................................................................................................................... vi Section 1: Overview of the Project ......................................................................................1 Introduction ....................................................................................................................1 Background ....................................................................................................................2 Problem Statement .........................................................................................................3 Purpose Statement ..........................................................................................................4 Project Goal and Outcome .............................................................................................5 Goal…. .................................................................................................................... 5 Outcomes ................................................................................................................ 5 Framework/Model for the Project ..................................................................................6 IOWA Model .......................................................................................................... 6 Nature of the Project ......................................................................................................6 Definition of Terms........................................................................................................7 Assumptions ...................................................................................................................7 Scope & Delimitations ...................................................................................................8 Limitations .....................................................................................................................8 Significance of Project ...................................................................................................8 Summary ........................................................................................................................8 Section 2: Literature Review .............................................................................................10 Introduction ..................................................................................................................10 i Literature Search Strategy............................................................................................10 Theory/Model ..............................................................................................................11 IOWA Model ........................................................................................................ 11 Literature Review.........................................................................................................11 Summary ......................................................................................................................14 Section 3: Methods/Approach............................................................................................16 Introduction ..................................................................................................................16 Methods/Approach .......................................................................................................16 Evaluation ....................................................................................................................19 Summary ......................................................................................................................20 Section 4: Discussion and Implications .............................................................................21 Introduction ..................................................................................................................21 Evaluation/Findings and Discussion ............................................................................21 Project Outcomes .........................................................................................................23 Outcome 1 Literature Review ............................................................................... 23 Outcome 2 Policy and Procedure (Appendix A) .................................................. 23 Outcome 3 Curriculum Plan (Appendix B and I) ................................................. 24 Outcome 5 The Clinical Alarm Management Survey (Appendices D and G) .............................................................................................................. 25 Outcome 6 IOWA model into Designing the Practice Change (Appendix F) ............................................................................................................... 25 Outcome 9 Summative Evaluation of the Project (Appendix K) ......................... 26 ii Applicability to Health Care ........................................................................................27 Implications..................................................................................................................28 Practice .................................................................................................................. 29 DNP Use of Research in Practice ......................................................................... 29 Social Change ....................................................................................................... 30 Strengths and Limitations ............................................................................................30 Strengths ............................................................................................................... 30 Limitations ............................................................................................................ 31 Analysis of Self ............................................................................................................31 As Scholar ............................................................................................................. 31 As Practitioner ...................................................................................................... 31 As Project Developer ............................................................................................ 32 What Does this Project Mean for Future Professional Development? ................. 32 Summary and Conclusions ..........................................................................................33 Section 5: Scholarly Product for Dissemination ................................................................34 Purpose .........................................................................................................................34 References ..........................................................................................................................36 Appendix A: Patient Care Policy and Procedure ...............................................................41 Appendix B: Curriculum Plan ...........................................................................................43 Appendix C: PowerPoint Educational Module ..................................................................45 Appendix D: Clinical Alarm Management Survey ............................................................53 Appendix E: IOWA model ................................................................................................54 iii