Rainer Hoffmann, Jochen Michaelsen, Lukas Langenbrink, Mirlind Kastrati, Michal Piatkowski, Guido Hengemühle, Tobias Schüll and Matthias Lammers
Background: Need for a permanent control person and alarm fatigue are limitations of telemetry surveillance systems ending at the central surveillance monitor. This study evaluated an escalation system expanding the alarm sequence by smartphones.
Methods: Telemetry system with 26 monitoring units and WLAN based alarm escalation system to three smartphones (Care Event, Philips) was evaluated during 128 days regarding major arrhythmia alarm (MAA) frequency, escalation of alarms within the system and response times. ECG triggering the MAA, patient name and position are shown on the smartphone display. MAA are forwarded initially to smartphone one. Forwarding of MAA to two further smartphones is actively triggered or occurs automatically after 20 sec without response by smartphone one.
Results: During the analysis period 11576 MAA were forwarded, ranging from 15 to 238 alarms/day. The number of MAA was minimal at 11 pm and maximal at 8 am (ratio 1:1.8). In 69% only smartphone 1 was involved, in 31% occurred an escalation to smartphone 2 and in 13% to smartphone 3. The median MAA response time at the smartphone was 8 sec at daytime and 9 sec at nighttime. 14 min of running time could be saved on average every day by direct visit of the patient triggering an alarm and omission of the central monitoring system.
Conclusions: A smartphone based alarm escalation system redundancies the permanent presence of nursing staff at the central surveillance system. The multilevel surveillance system with smartphone based escalation allows low alarm response times and warrants excellent surveillance quality
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