The Not So Quiet Hospital Hazard That Needs Fixing: Alarm Fatigue

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False positives have been a ubiquitous technological challenge at least since warnings were first automated in the early electric age

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The Boston Globe reports on an ironic hospital hazard:

alarm fatigue -- a phenomenon that occurs when nurses become so desensitized to the constant beeping that they don't hear or ignore important warnings that a patient's condition might be worsening.

The second link in the Globe story is an infinite link back to itself; the sequel in its earlier series is here.

False positives are not limited to machine noises and screening test results. They have been a ubiquitous technological challenge at least since warnings were automated in the early electric age. The law enforcement magazine Police Patrol ("Community for Cops") reported in 2008:

The majority of burglar alarm activations are not by bad guys. False alarms account for 10 to 25 percent of all calls to the police. Each call usually requires the response of two officers for 20 minutes. In 2002, American police responded to 36 million alarm calls, costing $1.8 billion....

The problem is bad and is likely to get worse. Research into false burglar alarms is based on the approximately 32 million security alarm systems already installed in the United States. But every year another 3 million alarm systems are installed. A recent trend is the marketing of mobile alarm systems, which can be worn on clothing, handheld, or carried in a car. Some departments are already experiencing astronomical rises in their workloads. From 1985 to 2001, the Arlington (Texas) Police Department experienced a 494 percent increase in residential alarms and a 186 percent rise in commercial alarms. Ninety-nine percent of these alarms were false.

It's elementary psychology that ubiquitous warnings desensitize people. Think of the retail security alarms that are always going off in drugstores, and how often clerks disregard them. And consider the challenges of cigarette pack warnings, which I've discussed here.

Fortunately there's even more psychological research on alarm fatigue than the otherwise excellent Globe series suggests, for example here. The problem is transferring principles from the labs to actual products and hospital practices without adding more bureaucratic layers to health care. One conclusion I'd draw is that psychological literacy should be more prominent in the education and licensing of physicians, nurses, and medical engineers and technicians.

Image: loop_oh/Flickr.

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Edward Tenner is a historian of technology and culture, and an affiliate of the Center for Arts and Cultural Policy at Princeton's Woodrow Wilson School. He was a founding advisor of Smithsonian's Lemelson Center.

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