Evidence map›Paper›PMID 37562650›Full record

Trial reportBrazilian journal of anesthesiology (Elsevier)

Decreasing inconsistent alarms notifications: a pragmatic clinical trial in a post-anesthesia care unit.

Saullo Queiroz Silveira, Rafael Sousa Fava Nersessian, Arthur de Campos Vieira Abib, Leonardo Barbosa Santos, Fernando Nardy Bellicieri, Karen Kato Botelho, Helidea de Oliveira Lima, Renata Mazzoni de Queiroz, Gabriel Silva Dos Anjos, Hermann Dos Santos Fernandes and 3 more

Abstract readPragmatic Clinical Trial
In one paragraph

Trial report in Brazilian journal of anesthesiology (Elsevier). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Saullo Queiroz SilveiraHospital São Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, São Paulo, SP, Brazil.
Rafael Sousa Fava NersessianHospital São Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, São Paulo, SP, Brazil.
Arthur de Campos Vieira AbibHospital São Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, São Paulo, SP, Brazil.
Leonardo Barbosa SantosHospital São Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, São Paulo, SP, Brazil; Rede D'Or, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil.
Fernando Nardy BellicieriHospital São Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, São Paulo, SP, Brazil.
Karen Kato BotelhoSão Luiz Hospital (ITAIM), Rede D'Or, Departamento de Enfermagem, São Paulo, SP, Brazil.
Helidea de Oliveira LimaRede D'Or, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil.
Renata Mazzoni de QueirozHospital São Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, São Paulo, SP, Brazil.
Gabriel Silva Dos AnjosHospital São Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, São Paulo, SP, Brazil.
Hermann Dos Santos FernandesUniversity of Toronto, Mount Sinai Hospital, Department of Anesthesiology and Pain Medicine, Toronto, Canada.
Glenio B MizubutiQueen's University, Department of Anesthesiology and Perioperative Medicine, Kingston, Canada.
Joaquim Edson VieiraFaculdade de Medicina da Universidade de São Paulo (FMUSP), Departamento de Cirurgia, Anestesiologia, São Paulo, SP, Brazil.
Leopoldo Muniz da SilvaHospital São Luiz Unidade Itaim, Rede D'Or - Equipe de Anestesia CMA, Departamento de Anestesiologia, São Paulo, SP, Brazil; Rede D'Or, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil. Electronic address: leopoldo.muniz@saoluiz.com.br.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlarms alert healthcare professionals of deviations from normal/physiologic status. However, alarm fatigue may occur when their high pitch and diversity overwhelm clinicians, possibly leading to alarms being disabled, paused, and/or ignored. We aimed to determine whether a staff educational program on customizing alarm settings of bedside monitors may decrease inconsistent alarms in the Post-Anesthesia Care Unit (PACU).

methodsThis is a prospective, analytic, quantitative, pragmatic, open-label, single-arm study. The outcome was evaluated on PACU admission before (P1) and after (P2) the implementation of the educational program. The heart rate, blood pressure, and oxygen saturation alarms were selected for clinical consistency.

resultsA total of 260 patients were included and 344 clinical alarms collected, with 270 (78.4%) before (P1), and 74 (21.6%) after (P2) the intervention. Among the 270 alarms in P1, 45.2% were inconsistent (i.e., false alarms), compared to 9.4% of the 74 in P2. Patients with consistent alarms occurred in 30% in the P1 and 27% in the P2 (p = 0.08). Patients with inconsistent alarms occurred in 25.4% in the P1 and in 3.8% in the P2. Ignored consistent alarms were reduced from 21.5% to 2.6% (p = 0.004) in the P2 group. The educational program was a protective factor for the inconsistent clinical alarm (OR = 0.11 [95% CI 0.04-0.3]; p < 0.001) after adjustments for age, gender, and ASA physical status.

conclusionCustomizing alarm settings on PACU admission proved to be a protective factor against inconsistent alarm notifications of multiparametric monitors.

Indexed as

Clinical AlarmsAdultAgedAnesthesia Recovery PeriodFemaleHeart RateHumansMaleMiddle AgedMonitoring, PhysiologicProspective StudiesAnesthesia recovery periodClinical alarmsData managementMonitoringPost-anesthetic care unit

Identifiers

PMID37562650
PMCPMC11148498

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.