Increasing Timely Identification of Patients Who have Become Disconnected from High Flow Nasal Cannula (HFNC) by Adjusting the Urgency Level of Pulse-Oximeter Alarms

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In recent years, High Flow Nasal Cannula (HFNC) oxygen use has increased as a first line treatment for respiratory failure. The HFNC device has many alarms to alert the provider if there are issues with the device but it does not have any alarms to notify the provider that a patient has become disconnected. With the increased use of HFNC to treat respiratory failure especially in COVID-19 patients, a need was identified to make staff aware of these patients quickly. Low pulse-oximeter readings are one way to identify these patients. Low pulse-oximeter alarms are set to a warning level of urgency. The warning level alarms have a greater risk of contributing to alarm fatigue because too many waring level alarms sound that do not require action. A crisis level alarm is less frequent decreasing the risk of alarm fatigue. The goal of this project is to increase timely awareness of patients becoming disconnected from HFNC by creating a standard process to adjust the urgency of pulse-oximeter alarms for these patients. Results of this study show a decrease in event reports involving HFNC. A limitation of this study is the lack of ability to obtain data on response times. Evaluation of the project relies on event reports and audits of alarm urgency. Future studies could be done to assess response times if data becomes available.



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