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Journal of Nursing Care Quality 2019Nurses can be exposed to hundreds of alarms during their shift, contributing to alarm fatigue.
BACKGROUND
Nurses can be exposed to hundreds of alarms during their shift, contributing to alarm fatigue.
PURPOSE
The purposes were to explore similarities and differences in perceptions of clinical alarms by labor nurses caring for generally healthy women compared with perceptions of adult intensive care unit (ICU) and neonatal ICU nurses caring for critically ill patients and to seek nurses' suggestions for potential improvements.
METHODS
Nurses were asked via focus groups about the utility of clinical alarms from medical devices.
RESULTS
There was consensus that false alarms and too many devices generating alarms contributed to alarm fatigue, and most alarms lacked clinical relevance. Nurses identified certain types of alarms that they responded to immediately, but the vast majority of the alarms did not contribute to their clinical assessment or planned nursing care.
CONCLUSIONS
Monitoring only those patients who need it and only those physiologic values that are warranted, based on patient condition, may decrease alarm burden.
Topics: Auditory Fatigue; Clinical Alarms; Critical Care Nursing; Focus Groups; Humans; Intensive Care Units, Neonatal; Monitoring, Physiologic; Nursing Staff, Hospital; Obstetrics and Gynecology Department, Hospital
PubMed: 29889722
DOI: 10.1097/NCQ.0000000000000335 -
Journal of Neurophysiology Dec 2013The neural response to a sensory stimulus tends to be more strongly reduced when the stimulus is preceded by the same, rather than a different, stimulus. This...
The neural response to a sensory stimulus tends to be more strongly reduced when the stimulus is preceded by the same, rather than a different, stimulus. This stimulus-specific adaptation (SSA) is ubiquitous across the senses. In hearing, SSA has been suggested to play a role in change detection as indexed by the mismatch negativity. This study sought to test whether SSA, measured in human auditory cortex, is caused by neural fatigue (reduction in neural responsiveness) or by sharpening of neural tuning to the adapting stimulus. For that, we measured event-related cortical potentials to pairs of pure tones with varying frequency separation and stimulus onset asynchrony (SOA). This enabled us to examine the relationship between the degree of specificity of adaptation as a function of frequency separation and the rate of decay of adaptation with increasing SOA. Using simulations of tonotopic neuron populations, we demonstrate that the fatigue model predicts independence of adaptation specificity and decay rate, whereas the sharpening model predicts interdependence. The data showed independence and thus supported the fatigue model. In a second experiment, we measured adaptation specificity after multiple presentations of the adapting stimulus. The multiple adapters produced more adaptation overall, but the effect was more specific to the adapting frequency. Within the context of the fatigue model, the observed increase in adaptation specificity could be explained by assuming a 2.5-fold increase in neural frequency selectivity. We discuss possible bottom-up and top-down mechanisms of this effect.
Topics: Acoustic Stimulation; Adaptation, Physiological; Adult; Auditory Cortex; Auditory Fatigue; Evoked Potentials, Auditory; Female; Humans; Male; Models, Neurological
PubMed: 24047909
DOI: 10.1152/jn.01015.2012 -
Ear and Hearing 1982Auditory abnormalities were evaluated in human albinos using temporary threshold shift and dichotic listening tasks. Albinos exhibited a greater temporary threshold... (Comparative Study)
Comparative Study
Auditory abnormalities were evaluated in human albinos using temporary threshold shift and dichotic listening tasks. Albinos exhibited a greater temporary threshold shift than did normally pigmented individuals after exposure to a fatiguing tone. In the dichotic listening task, albinos demonstrated a significantly larger right ear advantage than normally pigmented individuals. These results support earlier work indicating that hemispheric asymmetries are present in a albino auditory system and suggest that abnormalities may be present at the cochlear level as well.
Topics: Adult; Albinism; Auditory Fatigue; Cochlea; Dichotic Listening Tests; Eye Color; Female; Hearing; Humans; Male; Melanins
PubMed: 7117717
DOI: 10.1097/00003446-198207000-00004 -
The Journal of Auditory Research Oct 1980The action potential (AP), summating potential (SP), and cochlear microphonic (CM) were measured in rats in response either to clicks or pure tones prior to and...
The action potential (AP), summating potential (SP), and cochlear microphonic (CM) were measured in rats in response either to clicks or pure tones prior to and following 3 min of exposure to pure tones at a level 5 db less than that which produced maximum CM. The ratio, in decibels, between pre-exposure and post-exposure potentials, for the same exposure and probe stimulus parameters, was taken as an index of decrement. The relative reduction in voltage resulting from the exposure was greater for the SP than for the AP when these potentials were elicited with 20-msec probe tone bursts between 70-80 db SPL having instantaneous rise times. However, for weaker probe levels within 20 db of that yielding AP potentials of 1 mu V, the AP and SP bpth exhibited similar losses. The CM and the click-evoked AP showed essentially no decrement. These results suggest that the SP might be a better indicator of noise-induced auditory decrement (fatigue?) than the CM. Theories of central auditory fatigue may be based on incorrect interpretations of previously published data obtained from cochlear and neural recordings.
Topics: Action Potentials; Animals; Auditory Fatigue; Auditory Threshold; Cochlear Microphonic Potentials; Noise; Rats
PubMed: 7349308
DOI: No ID Found -
Journal of Comparative and... Dec 1960
Topics: Anesthetics; Animals; Auditory Fatigue; Cats; Cerebral Cortex; Felis; Hearing; Hearing Tests
PubMed: 13764750
DOI: 10.1037/h0043462 -
Dimensions of Critical Care Nursing :... 2017Excessive clinical alarms have inundated health care for years. Multiple governing bodies, organizations, and facilities have deemed alarm management a priority. Alarm...
BACKGROUND
Excessive clinical alarms have inundated health care for years. Multiple governing bodies, organizations, and facilities have deemed alarm management a priority. Alarm management is a multifaceted problem that affects all health care organizations and clinical staff, especially those in critical care units. Ultimately, the lack of knowledge regarding nurses' perceptions to alarm management and alarm fatigue creates patient safety chiasms.
OBJECTIVES
The purpose of this quality improvement project was to understand nurses' perceptions of alarm fatigue (utilizing the Healthcare Technology Foundation's Clinical Alarms Committee Survey) while implementing interventions that improve patient safety.
METHODS
The design of this qualitative study is an electronically distributed survey to 31 nurses who work in critical care. The Healthcare Technology Foundation clinical alarms survey has 36 questions with various answering strategies distributed (with permission) via e-mail access by BlueQ through Creighton University.
RESULTS
Twenty-six respondents (n = 26) completed the survey, with 42% being intensive care unit nurses and 58% being progressive care unit nurses. The majority of nurses (n = 23, 88%) agreed that nuisance alarms occur frequently and disrupt patient care (n = 25, 96%). A lack of standardized method was noted to alarm management and parameter changes. Multiple patterns emerged that initiated the need for further examination and improvement.
DISCUSSION
Following the survey, themes emerged, and changes were implemented including the following: an alarm management policy was created, tools were provided to staff for easy usage, staff were educated using hands-on practice at an annual training summit, and sustainability was created through continuation of alarm management assessment and improvement.
Topics: Attitude of Health Personnel; Auditory Fatigue; Clinical Alarms; Critical Care; Critical Illness; Humans; Inservice Training; Nursing Staff, Hospital; Organizational Policy; Qualitative Research; Quality Improvement; Surveys and Questionnaires
PubMed: 27902661
DOI: 10.1097/DCC.0000000000000220 -
The Journal of the Acoustical Society... Sep 2015One of the most widely recognized effects of intense noise exposure is a noise-induced threshold shift—an elevation of hearing thresholds following cessation of the... (Review)
Review
One of the most widely recognized effects of intense noise exposure is a noise-induced threshold shift—an elevation of hearing thresholds following cessation of the noise. Over the past twenty years, as concerns over the potential effects of human-generated noise on marine mammals have increased, a number of studies have been conducted to investigate noise-induced threshold shift phenomena in marine mammals. The experiments have focused on measuring temporary threshold shift (TTS)—a noise-induced threshold shift that fully recovers over time—in marine mammals exposed to intense tones, band-limited noise, and underwater impulses with various sound pressure levels, frequencies, durations, and temporal patterns. In this review, the methods employed by the groups conducting marine mammal TTS experiments are described and the relationships between the experimental conditions, the noise exposure parameters, and the observed TTS are summarized. An attempt has been made to synthesize the major findings across experiments to provide the current state of knowledge for the effects of noise on marine mammal hearing.
Topics: Animals; Auditory Fatigue; Auditory Threshold; Caniformia; Cetacea; Environmental Exposure; Female; Hearing Loss, Noise-Induced; Male; Noise; Sound
PubMed: 26428808
DOI: 10.1121/1.4927418 -
Acta Oto-rhino-laryngologica Belgica 1979
Topics: Adult; Audiometry; Auditory Fatigue; Hearing Loss, Noise-Induced; Humans; Male; Middle Aged; Time Factors
PubMed: 554429
DOI: No ID Found -
Acta Oto-laryngologica. Supplementum 1950
Topics: Acclimatization; Adaptation, Physiological; Auditory Fatigue; Hearing; Hearing Tests
PubMed: 14856693
DOI: No ID Found -
Otolaryngology--head and Neck Surgery :... 1982Possible harmful effects of a high-cholesterol diet on auditory function were suggested by our previous work in rabbits, in which evoked potentials were measured from a... (Comparative Study)
Comparative Study
Possible harmful effects of a high-cholesterol diet on auditory function were suggested by our previous work in rabbits, in which evoked potentials were measured from a chronic electrode inserted into the inferior colliculus. However, serum cholesterol levels in those rabbits tended to be extraordinarily high, i.e., more than 1,500 mg/dL. Chinchillas were used in the present work as an animal model to study the relationship between hypercholesterolemia and auditory dysfunction. One percent cholesterol in standard Chinchow was fed to chinchillas for three months. The experimental groups showed a high mean cholesterol level of 437 +/- 394 mg/dL (N = 9). Isopotential curve of the cochlear microphonics, threshold of action potentials (AP), and endocochlear DC potential did not differ from those in the control group. When moderately intense sound (12 kHz, 95 dB SPL) was given for ten minutes, however, the reduction in AP threshold was significantly greater (P = .036) in the cholesterol group. It is postulated that hypercholesterolemia may be one of the factors involved in differential susceptibility to noise.
Topics: Animals; Auditory Fatigue; Auditory Threshold; Chinchilla; Cholesterol; Cochlear Microphonic Potentials; Female; Hypercholesterolemia; Male; Rabbits; Risk Factors; Species Specificity
PubMed: 10994435
DOI: 10.1177/019459988209000624