3 Barriers to Implementing Good Alarms

Date: August 18, 2014

What are common barriers that institutions face when trying to enable good alarms? Below we review 3 barriers that consistently come up and recommendations on how to overcome them:

1. Enabling all alarms on monitoring equipment to “on” as a default

Challenge: If every alarm on every device is alerting, there can be problems with duplicative or irrelevant alarms. Institutional and unit stakeholders must determine what alarms to enable based on your institutions’ risk tolerance, the unit type and the patient mix.

Recommendation: Start by reviewing the alarms in your unit and determine if they are good alarms (See 8 Characteristics of a “Good Alarm” blog).

2. Inaccurate default settings for your unique patient mix

Challenge: Determining alarm default settings for your unit can be a daunting task. While device vendors often provide recommended settings for their alarms, there are few publications that review population characteristics. Even so, those publications generally focus on healthy patients. This can be especially problematic in pediatric populations where patients are at varying stages of development.

Recommendation: Analyze your alarm settings for your unique patient population and devices. Data directly from the monitoring devices can be used to build consensus in your Alarm Steering Committee with consideration to your risk profile for implementing device setting changes.

3. Lack of education and communication on characteristics of a good alarm across the care team

Challenge: It is not uncommon to adjust alarm settings for an individual patient. When alarms are set it should be with the intention to alert the care team to take action, it should not be to indicate a message or status (i.e. no action is required). If this expectation is not clearly communicated with the care team, you can see dramatic increases in alarm loads for a given patient.

Recommendation: Encourage good alarm practices by educating your care teams on what makes a good alarm, institutional policies on alarms, and how they can directly impact alarm load in their daily environment.


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