There have been increased reports of nursing and medical staff showing slower or reduced responses to critical equipment alarms. There are several theories about why this is happening, including high frequency of alarm call, that may often not require action and represent non-urgent or even non-pathological changes. As such, these causes “alarm fatigue” and it may even be unfeasible to attend every alarm for every patient, with staff shortages and an increase in single-bed patient rooms compared to ward usage. This is expected to rise with increased concerns around infection control. Concerns around the implications of healthcare professionals attending alarms less frequently include delays in medication administration and monitoring, response to changes in patient health, and response to emergencies. This, inevitably, leads to litigation claims and complaints made against staff and trusts based on their conduct.

The estimated annual cost to the NHS of harm arising from clinical activity, covered by the Clinical Negligence Scheme was £8.3 billion in 2019/2020. Although this has reduced from 2018/2019, when this was £8.8 billion, this is still a significant financial burden on the NHS, and represents patient dissatisfaction and/or risk that is incredibly important to address. With stretched resources and understaffing, these are costs that cannot be met without compromising resource availability and allocation nationwide, and a solution is needed to reduce these incidents, and improve working conditions for both staff and patients through the development of better workflow and alert systems on wards.

“BEAMS, a bedside alarm system, and its potential for improving response times for inpatients in hospitals“

BEAMS (Bedside Equipment Alarm Monitoring System) has been developed by Sheffield Children’s Hospital and Tutum Medical from Chesterfield, and hopes to offer just such a solution. The BEAMS monitoring system is designed to keep track of single-bed patient rooms and small wards of 4-6 bay wards. It combines a digital platform with an audio system, and nurse consoles connected to a cloud or locally stored database, according to need, and allows for monitoring of patients who are not directly visible or easily heard from the nurse’s station on the ward. The system can also give a spoken notification and a visual display, informing nurses of where care is needed Describe as ‘the world’s only acoustic bedside equipment critical alarm monitoring system’, BEAMS has been successfully trialled within Sheffield’s Children’s Hospital in 70 single-occupancy rooms, across 6 wards. A trial comparing the alarm data collected before and after the implementation of the BEAMS system on wards. First, BEAMS was ‘educated’ to recognise and differentiate between different medical device alarms used on the ward, and distinguish it from ambient hospital noise. Eight BEAMS units were then trialled in eight single-occupancy rooms on a ward, and baseline data was collected over the course of 8 weeks, without BEAMS alerts. Then, the BEAMS units were connected to the nurse call system on the ward, alerting when a bedside alarm went off and directing staff to the location; this data was collected for a further 8 weeks. Data from this trial showed that the use of BEAMS reduced the number of alarms that had a response time greater than 2 minutes by 78%; a response time of greater than 5 minutes by 88%, and a response time of greater than 10 minutes by 95%.

“The BEAMS system improves patient care without increasing staffing levels; it is a great example of managing costs and improving patient safety through innovation.”

Professor Derek Burke FRCSEd FRCEM FRCPCH, Former Medical Director, Sheffield Children’s Hospital.

In terms of improving care without increasing cost, and helps identify gaps in resources or training, bolstering staff in their feedback, helping trusts direct resources and funding, informing recruitment and shift patterns, and optimising patient care in a data-driven manner. Importantly, the use of systems like BEAMS reassures patients and their families that their quality of care is a priority, and that efforts are being make to overcome the collateral effects of clinical setting work phenomena such as alarm fatigue and stretched resources, through technological innovations that improve conditions for staff and patients alike.