The proposed super alarm might have a dashboard that looks something like the above graphic. This dashboard displays a numeric score, which the super alarm algorithm generates and which represents the probability of risk for a patient. Users can then drill down into detailed patient information with one click.
August 2016 • By Andrew Schwartz

The technology in a hospital intensive care unit (ICU) is extraordinary in its ability to pick up the slightest alterations in bodily functions and recognize when they slip out of the “normal” range. But as most ICU nurses understand all too well, having all of that clinical information does not always translate into improvements in patient care.

For one, despite their remarkable sensitivity, ICU monitors still miss some critical clinical events, in part because they cannot adequately synthesize disparate data points to give clinicians appropriate early warnings. Equally important, a UCSF study found that there were 187 audible alarms per bed per day in the ICU, with a false-positive rate of over 88 percent for arrhythmia alarms. Put that in the context of other noise in the ICU and all of the other duties nurses must perform, and you begin to understand the concept of alarm fatigue. It’s no surprise that in many settings, clinicians ignore alarms, turn them down or turn them off, leading to a nationwide epidemic that goes beyond the ICU to other hospital units.

It also explains why an interdisciplinary team of UC San Francisco researchers, led by Xiao HuMichele Pelter and Richard Fidler from UC San Francisco School of Nursing, is working furiously to create and test a “super alarm.” This device would aggregate disparate data, capture trending patterns and filter out false alarms, so clinicians are, in theory, only and always alerted when there is a situation that truly demands clinical attention.

The team has already shown they can achieve 90 percent sensitivity in predicting ICU cases where a patient is in need of resuscitation – known in hospitals as code blue – and is on track to complete a prospective National Institutes of Health (NIH)-funded clinical study by the end of 2017.

The Dean's Blog | David Vlahov

Over the last weeks, the violence in Louisiana, Minnesota and Dallas shook the nation. Stark images of the shooting deaths of black men through streaming video escalated the issues of firearm fatalities, systemic racism and excessive police violence. The ambush and shooting deaths of the Dallas and Baton Rouge police officers stunned us. We mourn and express our condolences to the relatives and friends whose loss is personal and to communities whose trauma is collective.

However, as health care professionals, we cannot leave it at that; we cannot sit still while efforts to address these calamities continue to be frustrated. Nurses need to be among those helping the nation make sense of the conversation.

Featured Articles

August 2016
A Voyage Without a Map: Improving Alarm Safety at UCSF Medical Center – Alarm safety is a significant problem with no easy solutions. UCSF Medical Center and UCSF San Francisco School of Nursing are approaching it as a team effort.
August 2016
Jyu-Lin Chen Named Inaugural Ting Tsung and Wei Fong Chao Presidential Chair in Global Health Nursing – UCSF global health scholar Jyu-Lin Chen has been named the School of Nursing’s first Presidential Chair in Global Health Nursing.
August 2016
New Mortara Fellowships to Explore and Improve ECG Monitoring – The UCSF School of Nursing has created two new fellowships to support researchers exploring ECG monitoring.
August 2016
Big Data, mHealth and the Pursuit of Precision Behavior Change – Yoshimi Fukuoka and her colleagues explore whether combining behavior science, big data, advanced analytics and mHealth applications can help people achieve the type of behavior change that can prevent or ease the burden of cardiovascular disease, diabetes and other chronic illnesses.
August 2016
Can the Quantified Self Deliver Sustainable Health Benefits? – Mobile diet and exercise apps are all the rage. Nurse scientist Yoshimi Fukuoka offers one model for shaping these devices so they help individuals make lasting lifestyle changes for healthier lives.