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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.
In the ED, we have monitors in each room and then two central monitors at the main nurses’ stations. More often than not, something is ringing/alarming on that central monitor whether it be because a patient’s tele lead came off or one of their vital signs is outside of the normal limit. It can sometimes be second nature for us to silence the alarm with the click of one button. However, although it doesn’t happen often, the monitor will alarm when a lethal rhythm is detected. Due to alarm fatigue or just simple distraction, the nurse could possibly silence this like they would for the less serious notifications. That patient’s care could be delayed, or they may not receive care it at all during this crucial time, resulting in an adverse outcome or sentinel event. I believe this could be seen as neglect.
According to Jacoby and Scruth (2017), negligence is defined as “doing something or failing to do something that a prudent, careful, and reasonable nurse would do or not do in the same situation” (p. 183). They also go on to mention that negligence in nursing tends to be unintentional rather than intentional (p. 183).
I firmly believe most nurses would not silence an alarm with the intention of harming the patient. From an outsider’s perspective though, I could certainly see grounds for a legal case based on nurse negligence. It’s so unfortunate because we deal with so much on a daily basis and clearly, the evidence (mentioned below) supports us. However, I don’t know that alarm fatigue would be an arguable defense in a legal case.

What does evidence reveal about alarm fatigue and distractions in healthcare when it comes to patient safety?
According to Kathleen Gaines with (2019), up to 99% of all alarms are false, which has contributed to alarm fatigue. Nurses are only human and it’s easier said than done to respond swiftly to all alarms if you consider this statistic.
Gaines (2019) also goes on to list some concerning statistics related to alarm injuries over the past ten years:
One study showed that >85% of all alarms in a particular unit were false.
A hospital reported an average of one million alarms going off in a single week.
A children’s hospital reported 5,300 alarms in a day – 95% of them false.
A hospital reported >350 alarms per patient per day in the intensive care unit

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