With the improvement of the quality of clinical diagnosis and treatment, the traditional scheduled "ward round" mode cannot meet the demands for real-time monitoring of acute and critically ill patients. This paper introduces the Storm, a real-time data stream processing technology and its application in the real time disease early warning system. By collecting the clinical data flow and calculating the MEWS scores in real time, the system can identify the potential deterioration of the disease, and promptly notify the medical staff. Score calculation results can be stored for further analysis and presentation as well.
Clinical Alarms ; Critical Illness ; Humans

This paper proposes a clinical alarm management system based on the theory of the closed loop control. The alarm management mechanism can be divided into the expected standard, improving execution rule, rule execution, medical devices with alarm functions, results analysis strategy and the output link. And, we make relevant application and discussion. Results showed that the mechanism can be operable and effective.
Clinical Alarms ; Decision Support Systems, Clinical

Medical electrical equipment--modular alarm system to meet YY 0709-2009 requirements and design, through the design of both hardware and software, low/medium/high three priority audible alarm visual alarm information to be verified by testing the same time, now the alarm system has been put into use on a portable infusion device remote microcomputer systems.
Clinical Alarms ; Equipment Design ; Software Design

This paper analyzed current problems and challenges facing hospitals in alarm management both abroad and at home. Based on a survey conducted on alarm management in hospitals, plus an analysis on different kinds of data interfaces and data exchange protocols of the medical equipment used in ICUs, a solution of alarm management is put forwarded which is based on alarm information integration and processing. It aims at improving medical equipment alarm management and reducing relevant adverse events.
Automatic Data Processing ; Clinical Alarms ; Intensive Care Units

This paper introduces several test methods of characteristics of alarm indicator lights which can be used in the medical alarm system to verify the compliance of YY 0709-2009. These methods include the direct measurement of the pulse current supply of the alarm signals, image analysing of a video and reception by photoelectric sensor. After the comparation of the advantages and disadvantages among these methods, this paper proposes a new method of signal reception. This method which used a silicon photocell as the sensor with light filter in its front, and amplified circuit in the output end then used an oscillograph as the reviewer, has resolved the testing difficulties of the flashing signal simulating by LCD, and can be applied to test the alarm indicator lights in any medical electrical equipment.
Clinical Alarms ; Equipment Design ; Signal Processing, Computer-Assisted

This paper discusses the test method of auditory alarm in YY0709-2009 by analyzing the test requirement and process. Consider of the acoustic theory and the problem during the test, it provides some suggestions for improvement.
Acoustics ; Clinical Alarms ; Equipment Failure ; Equipment Safety ; methods

OBJECTIVE: The patient monitors were used to explore the alarm fatigue in a cardiac care unit and to investigate the awareness and reaction of nurse to alarms. METHODS: A semi-structured survey was taken to acquire nurses' feeling and knowledge about monitoring alarm. Three full-time researchers were scheduled to track the alarms with annotations, and analyze the alarm data of 12 patient monitors using central monitoring system. RESULTS: A total of 72 310 unique alarms occurred in the 67-day study period. About 75.7% of them were physiological alarms and less than 10% of medium-low alarms were false positives. The average alarm rate was 128 alarms/patient-day. CONCLUSIONS There remains alarm fatigue in CCU, the alarm accuracy has improved than the past by applying new technologies. In some cases, clinicians will pay more attention to trend alarm and combination alarm.
Arrhythmias, Cardiac ; Clinical Alarms ; Electrocardiography ; Humans ; Monitoring, Physiologic ; Surveys and Questionnaires

OBJECTIVES: The purpose of this descriptive study was to investigate the current situation of clinical alarms in intensive care unit (ICU), nurses' recognition of and fatigue in relation to clinical alarms, and obstacles in alarm management. METHODS: Subjects were ICU nurses and devices from 48 critically ill patient cases. Data were collected through direct observation of alarm occurrence and questionnaires that were completed by the ICU nurses. The observation time unit was one hour block. One bed out of 56 ICU beds was randomly assigned to each observation time unit. RESULTS: Overall 2,184 clinical alarms were counted for 48 hours of observation, and 45.5 clinical alarms occurred per hour per subject. Of these, 1,394 alarms (63.8%) were categorized as false alarms. The alarm fatigue score was 24.3 +/- 4.0 out of 35. The highest scoring item was "always get bothered due to clinical alarms". The highest scoring item in obstacles was "frequent false alarms, which lead to reduced attention or response to alarms". CONCLUSIONS: Nurses reported that they felt some fatigue due to clinical alarms, and false alarms were also obstacles to proper management. An appropriate hospital policy should be developed to reduce false alarms and nurses' alarm fatigue.
Clinical Alarms* ; Critical Care* ; Critical Illness ; Fatigue* ; Humans ; Intensive Care Units*

OBJECTIVE: To retrieve the evidence for threshold setting of multi-parameter electrocardiograph (ECG) monitors in intensive care unit (ICU), and summarize the best evidence. METHODS: After literature retrieval, clinical guidelines, expert consensus, evidence summary and systematic review that met the requirements were screened. Guidelines were evaluated by the appraisal of guidelines for research and evaluation II (AGREE II), expert consensus and systematic review were evaluated by the Australian JBI evidence-based health care center authenticity evaluation tool, and evidence summary was evaluated by the CASE checklist. High-quality literature was selected to extract evidence related to the use and setup of multi-parameter ECG monitors in the ICU. RESULTS: A total of 19 literatures were included, including 7 guidelines, 2 expert consensus, 8 systematic reviews, 1 evidence summary, and 1 national industry standard. After evidence extraction, translation, proofreading and summary, a total of 32 pieces of evidence were integrated. The included evidence involved the environmental preparation for the application of the ECG monitor, the electrical requirements of the ECG monitor, ECG monitor use process, ECG monitor alarm setting principles, ECG monitor alarm heart rate or heart rhythm monitoring setting, ECG monitor alarm blood pressure monitoring setting, ECG monitor alarm respiratory and blood oxygen saturation threshold setting, alarm delay warning time setting, adjusting alarm setting method, evaluating alarm setting time, improving the comfort of monitoring patients, reducing nuisance alarm report the occurrence, alarm priority processing, alarm intelligent processing and so on. CONCLUSIONS This summary of evidence involves many aspects of the setting and application of ECG monitor. According to the latest guidelines and expert consensus, it is updated and revised to guide healthcare workers to monitor patients more scientifically and safely, and aims to ensure patient safety.
Humans ; Clinical Alarms ; Australia ; Intensive Care Units ; Arrhythmias, Cardiac ; Electrocardiography ; Monitoring, Physiologic

OBJECTIVE: The patient monitors were used to explore the alarm actuality in a ICU and NICU to investigate the awareness and reaction of medical staff to alarms. METHODS: A series of surveys and interviews were taken to acquire clinicians' feelings and attitudes to monitoring alarms. The researchers were scheduled to track the alarms with annotations, and collect the alarm data of patient monitors using central monitoring system. RESULTS: A total of 235 387 and 67 783 alarms occurred in ICU and NICU respectively. The average alarm rate was about 142 alarms/patient-day in ICU and 96 alarms/patient-day in NICU. CONCLUSIONS There remains alarm fatigue in ICU and NICU, the main reason is the large number of false alarms and clinically irrelevant alarms. In addition, patient monitor is still in the level of threshold alarms or combined alarms, the data integrity and intelligence level need to be improved in future.
Clinical Alarms ; Electrocardiography ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Monitoring, Physiologic