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The Problem

What is the problem?

There are an increasing number of single-bed patient rooms in UK hospitals, increasing the risk of alarms going unheard through walls and closed doors (this has been exacerbated during Covid with more single bed rooms and closed wards for infection control), this increases the risk of major incidences, such as:
  • Patients failing to get the prescribed amount of medication
  • Deterioration of patient’s health
  • Serious injury
  • Death

Potential Impact

From a clinical perspective a failure to respond to alarms can affect the patient in a number of ways, from a failure to receive correct treatment, to a failure to receive prescribed fluids or nutrition, or the right amount of medication. Most concerning is when the alarm is for monitors of cardiac function and blood oxygen saturation. A failure to respond to alarms can lead to the deterioration of the patient’s health, serious injury and even death.

The potential impact on the patient can lead to extended hospital stays and often increased anxiety that the alarm isn’t being responded to, leading to reduced sleep and poor overall opinion of nurses’ ability to meet personal needs. The resulting poor patient feedback and low family and friends score can be detrimental to the hospital.

Staff experience and the effect on staff morale, particularly during Covid is immense. Reports of nursing staff walking wards and corridors to monitor for alarms and inability to prioritise alarm responses are increasing daily leading to reduced time for patient care, alarm fatigue and the potential for a serious event which can impact on mental wellbeing, job satisfaction and increased stress.

Alarm Fatigue

Alarm fatigue occurs when clinicians experience high exposure to medical device alarms, causing alarm desensitization and leading to missed alarms or delayed response. As the frequency of alarms used in healthcare rises, alarm fatigue has been increasingly recognised as an important patient safety issue. Please refer to the References section for papers on Alarm Fatigue.

A busy ward can be noisy with multiple beeps, buzzes and bings which makes it hard to identify the patient, the type of device alarming and the seriousness of the event, especially if two or more devices have a similar tone.

Cost of Litigation

Over the last 5 complete financial years 3,266 claims were made against the NHS with the primary cause being Inadequate Nursing Care, Infusion Problems or Intubation Problems, a staggering cost of claims closed in the same period £247,260,120.
Year of Closure
Number of Claims
Damages Paid
NHS legal Costs Paid
Claimant Legal Costs Paid
Total Paid
2016/17
453
25,622,776
3,259,349
15,225,541
44,107,666
2017/18
489
27,651,517
2,972,264
15,200,183
45,823,965
2018/19
540
43,414,143
3,936,537
18,929,644
66,280,323
2019/20
528
24,240,443
3,443,143
15,055,562
42,739,148
2020/21
476
29,188,262
3,736,852
15,383,903
48,309,017
Grand Total
2,486
150,117,141
17,348,145
79,794,833
247,260,120
Table. Number and Cost of Claims Closed between financial years 2016/17-2020/21 with damages paid where the primary cause was Inadequate Nursing Care, Infusion Problems or Intubation Problems (includes the damages paid to date for any claims settled in a period.
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