Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review
Patient monitoring technology has been used to guide therapy and alert staff when a vital sign leaves a predefined range in the intensive care unit (ICU) for decades. However, large amounts of technically false or clinically irrelevant alarms provoke alarm fatigue in staff leading to desensitisation...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-08-01
|
| Series: | Frontiers in Digital Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fdgth.2022.843747/full |
| _version_ | 1811277476542808064 |
|---|---|
| author | Jonas Chromik Sophie Anne Ines Klopfenstein Sophie Anne Ines Klopfenstein Bjarne Pfitzner Zeena-Carola Sinno Bert Arnrich Felix Balzer Akira-Sebastian Poncette Akira-Sebastian Poncette |
| author_facet | Jonas Chromik Sophie Anne Ines Klopfenstein Sophie Anne Ines Klopfenstein Bjarne Pfitzner Zeena-Carola Sinno Bert Arnrich Felix Balzer Akira-Sebastian Poncette Akira-Sebastian Poncette |
| author_sort | Jonas Chromik |
| collection | DOAJ |
| description | Patient monitoring technology has been used to guide therapy and alert staff when a vital sign leaves a predefined range in the intensive care unit (ICU) for decades. However, large amounts of technically false or clinically irrelevant alarms provoke alarm fatigue in staff leading to desensitisation towards critical alarms. With this systematic review, we are following the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist in order to summarise scientific efforts that aimed to develop IT systems to reduce alarm fatigue in ICUs. 69 peer-reviewed publications were included. The majority of publications targeted the avoidance of technically false alarms, while the remainder focused on prediction of patient deterioration or alarm presentation. The investigated alarm types were mostly associated with heart rate or arrhythmia, followed by arterial blood pressure, oxygen saturation, and respiratory rate. Most publications focused on the development of software solutions, some on wearables, smartphones, or headmounted displays for delivering alarms to staff. The most commonly used statistical models were tree-based. In conclusion, we found strong evidence that alarm fatigue can be alleviated by IT-based solutions. However, future efforts should focus more on the avoidance of clinically non-actionable alarms which could be accelerated by improving the data availability.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021233461, identifier: CRD42021233461. |
| first_indexed | 2024-04-13T00:17:23Z |
| format | Article |
| id | doaj.art-e5ff24c9dab74eff9187f950434ff853 |
| institution | Directory Open Access Journal |
| issn | 2673-253X |
| language | English |
| last_indexed | 2024-04-13T00:17:23Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Digital Health |
| spelling | doaj.art-e5ff24c9dab74eff9187f950434ff8532022-12-22T03:10:54ZengFrontiers Media S.A.Frontiers in Digital Health2673-253X2022-08-01410.3389/fdgth.2022.843747843747Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature reviewJonas Chromik0Sophie Anne Ines Klopfenstein1Sophie Anne Ines Klopfenstein2Bjarne Pfitzner3Zeena-Carola Sinno4Bert Arnrich5Felix Balzer6Akira-Sebastian Poncette7Akira-Sebastian Poncette8Digital Health – Connected Healthcare, Hasso Plattner Institute, University of Potsdam, Rudolf-Breitscheid-Straße 187, Potsdam, GermanyCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Institute of Medical Informatics, Charitéplatz 1, Berlin, GermanyBerlin Institute of Health at Charité – Universitätsmedizin Berlin, Core Facility Digital Medicine and Interoperability, Charitéplatz 1,Berlin, GermanyDigital Health – Connected Healthcare, Hasso Plattner Institute, University of Potsdam, Rudolf-Breitscheid-Straße 187, Potsdam, GermanyCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Institute of Medical Informatics, Charitéplatz 1, Berlin, GermanyDigital Health – Connected Healthcare, Hasso Plattner Institute, University of Potsdam, Rudolf-Breitscheid-Straße 187, Potsdam, GermanyCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Institute of Medical Informatics, Charitéplatz 1, Berlin, GermanyCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Institute of Medical Informatics, Charitéplatz 1, Berlin, GermanyCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine, Charitéplatz 1, Berlin, GermanyPatient monitoring technology has been used to guide therapy and alert staff when a vital sign leaves a predefined range in the intensive care unit (ICU) for decades. However, large amounts of technically false or clinically irrelevant alarms provoke alarm fatigue in staff leading to desensitisation towards critical alarms. With this systematic review, we are following the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist in order to summarise scientific efforts that aimed to develop IT systems to reduce alarm fatigue in ICUs. 69 peer-reviewed publications were included. The majority of publications targeted the avoidance of technically false alarms, while the remainder focused on prediction of patient deterioration or alarm presentation. The investigated alarm types were mostly associated with heart rate or arrhythmia, followed by arterial blood pressure, oxygen saturation, and respiratory rate. Most publications focused on the development of software solutions, some on wearables, smartphones, or headmounted displays for delivering alarms to staff. The most commonly used statistical models were tree-based. In conclusion, we found strong evidence that alarm fatigue can be alleviated by IT-based solutions. However, future efforts should focus more on the avoidance of clinically non-actionable alarms which could be accelerated by improving the data availability.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021233461, identifier: CRD42021233461.https://www.frontiersin.org/articles/10.3389/fdgth.2022.843747/fullAlarm fatiguealarm managementalarm optimisationintensive care unitIT systempatient monitoring |
| spellingShingle | Jonas Chromik Sophie Anne Ines Klopfenstein Sophie Anne Ines Klopfenstein Bjarne Pfitzner Zeena-Carola Sinno Bert Arnrich Felix Balzer Akira-Sebastian Poncette Akira-Sebastian Poncette Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review Frontiers in Digital Health Alarm fatigue alarm management alarm optimisation intensive care unit IT system patient monitoring |
| title | Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review |
| title_full | Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review |
| title_fullStr | Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review |
| title_full_unstemmed | Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review |
| title_short | Computational approaches to alleviate alarm fatigue in intensive care medicine: A systematic literature review |
| title_sort | computational approaches to alleviate alarm fatigue in intensive care medicine a systematic literature review |
| topic | Alarm fatigue alarm management alarm optimisation intensive care unit IT system patient monitoring |
| url | https://www.frontiersin.org/articles/10.3389/fdgth.2022.843747/full |
| work_keys_str_mv | AT jonaschromik computationalapproachestoalleviatealarmfatigueinintensivecaremedicineasystematicliteraturereview AT sophieanneinesklopfenstein computationalapproachestoalleviatealarmfatigueinintensivecaremedicineasystematicliteraturereview AT sophieanneinesklopfenstein computationalapproachestoalleviatealarmfatigueinintensivecaremedicineasystematicliteraturereview AT bjarnepfitzner computationalapproachestoalleviatealarmfatigueinintensivecaremedicineasystematicliteraturereview AT zeenacarolasinno computationalapproachestoalleviatealarmfatigueinintensivecaremedicineasystematicliteraturereview AT bertarnrich computationalapproachestoalleviatealarmfatigueinintensivecaremedicineasystematicliteraturereview AT felixbalzer computationalapproachestoalleviatealarmfatigueinintensivecaremedicineasystematicliteraturereview AT akirasebastianponcette computationalapproachestoalleviatealarmfatigueinintensivecaremedicineasystematicliteraturereview AT akirasebastianponcette computationalapproachestoalleviatealarmfatigueinintensivecaremedicineasystematicliteraturereview |