A recent life-threatening allergic reaction to a prescription medication at Brockton Hospital was likely a result of the provider experiencing alert fatigue. As reported by the Boston Globe last week, a patient received a medication after its electronic order by a nurse practitioner and its electronic fulfillment by a pharmacist despite the on-screen alerts that warned both practitioners. This incident, along with many others, and more serious incidents at hospitals across the country have been attributed to “alert fatigue.” Alert fatigue occurs when medical providers see so many electronic alerts that they become desensitized and start to tune them out.
Initially thought to be a revolution in patient care, alerts were added to different medical devices, including electronic medical records. They were designed to warn doctors, nurses, and other providers of hazards associated with patient care. Such warnings have become so commonplace that many intensive care unit patients generate over 100 alerts per day – often without clinical relevance. These alerts distract providers during the course of treating their patients and occur so frequently that they are often ignored.
The issue of alert fatigue is so widespread that it was subject to a Boston Globe investigation and has been scrutinized by the Food and Drug Administration during its review process of medical devices with alarm sounds. The high number of alerts has been correlated not only with issues of patient care but also patient rehabilitation. The noise from the alerts themselves interfere with patients’ ability to sleep and ultimately recover.
Despite clear connections between alert fatigue and patient care, reducing the number of alerts has proved a difficult task. Hospitals and the FDA have tried to address this issue, however, patient care incidents related to alert fatigue continue to occur.
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