NR 351 Week 1 Discussion 1, Nurse of the Future Nursing Core Competencies

Week 6: Distractors in Our Environments (graded) This week's graded discussion topic relates to the following Course Outcome (CO). • CO6 Discuss the principles of data integrity, professional ethics, and legal requirements related to data security, regulatory requirements, confidentiality, and client's right to privacy. (PO 6) Distractions are everywhere. They may include cellphones, multiple alarms sounding, overhead paging, monitors beeping, and various interruptions that disrupt your train of thought. Give an example of an ethical or legal issue that may arise if a patient has a poor outcome or sentinel event because of a distraction such as alarm fatigue. What does evidence reveal about alarm fatigue and distractions in healthcare when it comes to patient safety? Good Afternoon! No Nor’easter this week!!! Although we did get 5 inches of snow yesterday. Alarms are noisy, colorful, and distracting ways that we as nurses determine that our patients are ok (Deb 2014). Alarms affect us all differently, the one thing that stays consistent is that alarms alert us to potentially life-threatening conditions. Nurses are taxed every day by demands from doctors, patients, families, and hospital administration. How are we supposed to take care of our patients and document and respond to every alarm that sounds? Sometimes the right thing to do is to change how our institution does things, but how? “Policy is developed through a multistage process that entails the following: recognition of a problem or issue, agenda setting, policy formation, adoption, implementation, and evaluation” (Hebda 2013). There are many legal and ethical issues that can arise from distractions. Alarm fatigue is definitely something that is an issue, working in the ER we have alarms going off all of the time. Many times, we will customize the alarms due to excessive noise. It is hard to have a patient who is in rapid a-fib at a rate of 150 and very stressed having alarms ringing constantly. As a nurse if I know that the patient’s heart rate is high, I am going to change the parameters on my alarms. Knowing that my patient is potentially on a Cardizem drip, I would set my alarm parameters to catch a heart rate that is dropping. I tend to customize my alarms for my patients need. This potentially can raise a problem because if I am busy in another bay, my colleague may not know that I have change those parameters. They may not know when to check on my patient. Another issue with the alarms is the constant ringing without there being a problem. I work with nurses who cannot stand the sound of the alarms going off, I also work with nurses who can work with alarms ringing and not even bat an eye. Our hospital has an initiative now where we do some training on alarm fatigue every year. This year the initiative is to discontinue telemetry as soon as medically possible. Telemetry alarms go off frequently, with increasing heart rates and electrodes coming off of patients. We tend to hear these alarms and ignore them especially if the last few times you checked on the patient they were fine. The problem with this is that one time they may not be fine and that could be the time you don’t check on them in a timely manner.