In 2010, a patient death at UMass Memorial Medical Center in Worcester involved a delayed response to alarms signaling the patient's fast heart rate and breathing problems, according to a Boston Globe report.
The patient's death marks the second time a patient at UMass Memorial died partly due to "alarm fatigue," a phenomenon that occurs when nurses, bombarded daily by hundreds of machine alarms that alert potential patient crises, tune out the sound due to overexposure.
According to the report, hospital nurses failed to respond to the second patient's monitoring system in 2010, which triggered an alarm because of a fast heart rate and potential breathing problems. Another patient at UMass Memorial died in 2007 after suffering cardiac arrest, which her monitor system failed to alert due to a dead battery. According to the report, hospital employees failed to respond to the system's alarm to replace the battery.
Although the most recent patient death occurred in 2010, the state Department of Public Health was not notified of the death until earlier this year. The department's report also cited the hospital for a medication error for the same patient, although it is not clear to what extent either the medication error or delayed response to the alarm caused the patient's death.
UMass Memorial officials declined to comment, though measures have been implemented after the 2007 death to prevent such incidents from occurring. Still, hospitals across the country struggle with "alarm fatigue," according to the report. One Johns Hopkins Hospital study showed staff members in a 15-bed unit were alerted with critical alarms 942 times a day, amounting to one critical alarm every 90 seconds.
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The patient's death marks the second time a patient at UMass Memorial died partly due to "alarm fatigue," a phenomenon that occurs when nurses, bombarded daily by hundreds of machine alarms that alert potential patient crises, tune out the sound due to overexposure.
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According to the report, hospital nurses failed to respond to the second patient's monitoring system in 2010, which triggered an alarm because of a fast heart rate and potential breathing problems. Another patient at UMass Memorial died in 2007 after suffering cardiac arrest, which her monitor system failed to alert due to a dead battery. According to the report, hospital employees failed to respond to the system's alarm to replace the battery.
Although the most recent patient death occurred in 2010, the state Department of Public Health was not notified of the death until earlier this year. The department's report also cited the hospital for a medication error for the same patient, although it is not clear to what extent either the medication error or delayed response to the alarm caused the patient's death.
UMass Memorial officials declined to comment, though measures have been implemented after the 2007 death to prevent such incidents from occurring. Still, hospitals across the country struggle with "alarm fatigue," according to the report. One Johns Hopkins Hospital study showed staff members in a 15-bed unit were alerted with critical alarms 942 times a day, amounting to one critical alarm every 90 seconds.
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