Racing to Eliminate Alarm Fatigue in Hospitals

Although remarkably complex, electrocardiography (ECG) and other patient-monitoring technology used in hospitals is alarmingly imperfect. It often misses life-threatening events, and as demonstrated by a 2014 study authored by professor emerita Barbara Drew, MS ’80, PhD ’90, RN, each ICU bed generates a daily average of 187 alarms, 89 percent of which are false-positives. It’s no surprise that nurses get “alarm fatigue” and ignore or switch alarms off, leading to a host of potential hazards. 

David Mortara, PhD, a leader in computerized ECG technology and innovation, aimed to change that in 2017, when he made a $25 million gift to establish the Center for Physiologic Research (CPR) in UCSF’s Department of Physiological Nursing, where he also serves as an associate professor. Mortara became associated with UCSF in 1994, when he and Drew discovered their mutual dedication to improving ECG equipment. 

The center’s long-term goal, Mortara said, is to attract resources and people eager to work together on solving the problem of alarm fatigue. “Our success will be not only what we’re able to do as a center but also what we can get the industry to do,” he said, adding that current monitoring devices are increasingly sensitive to every medical event, leaving anxious nurses and patients to pay the price. 

The center, directed by Fabio Badilini, PhD, has established an ECG database to identify specific predictors of adverse patient outcomes, reduce false alarm rates, and improve ECG technology as well as patient health and safety. The database, which includes UCSF intensive care unit bedside monitoring data dating back to April 2013, is growing dynamically as data from 96 ICU beds is constantly collected, with 207 additional telemetry beds to be added in the near future.  

The center also will recruit new faculty members and students and foster interdisciplinary research throughout UCSF’s clinical enterprise. Besides Badilini, the CPR team includes Mortara, who serves as chief scientist; nurse-scientist Michele Pelter, MS ’95, PhD ’01, RN, an associate professor in the Department of Physiological Nursing; and Priya Prasad, PhD ’16, MPH, an assistant professor in the Division of Hospital Medicine. Richard Fidler, PhD ’14, assistant adjunct professor in the Department of Anesthesia, also collaborates with the team as an informal member, Badalini says. 

If all goes as planned, hospital ICUs will be much quieter, patients will get a good night’s sleep, and nurses will be able to focus on providing much better care.