Does the architectural layout of a NICU affect alarm pressure? A comparative clinical audit of a single-family room and an open bay area NICU using a retrospective study design

Rohan Joshi, Henrica Van Straaten, Heidi Van De Mortel, Xi Long, Peter Andriessen, Carola Van Pul

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVES: To determine differences in alarm pressure between two otherwise comparable neonatal intensive care units (NICUs) differing in architectural layout-one of a single-family room (SFR) design and the other of an open bay area (OBA) design.

DESIGN: Retrospective audit of more than 2000 patient days from each NICU cataloguing the differences in the number and duration of alarms for critical and alerting alarms, as well as the interaction of clinicians with the patient monitor.

SETTING: Two level 3 NICUs.

RESULTS: A total of more than 150 000 critical and 1.2 million alerting alarms were acquired from the two NICUs. The number of audible alarms and the associated noise pollution varied considerably with the OBA NICU generating 44% more alarms per infant per day even though the SFR NICU generated 2.5 as many critical desaturation alarms per infant per day.

CONCLUSION: Differences in the architectural layout of NICUs and the consequent differences in delays, thresholds and distribution systems for alarms are associated with differences in alarm pressure.

LanguageEnglish
Article numbere022813
Number of pages10
JournalBMJ open
Volume8
Issue number6
DOIs
StatePublished - 1 Jun 2018

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Clinical Audit
Neonatal Intensive Care Units
Retrospective Studies
Pressure
Cataloging
Noise

Keywords

  • clinical audit
  • Neonatology

Cite this

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title = "Does the architectural layout of a NICU affect alarm pressure? A comparative clinical audit of a single-family room and an open bay area NICU using a retrospective study design",
abstract = "OBJECTIVES: To determine differences in alarm pressure between two otherwise comparable neonatal intensive care units (NICUs) differing in architectural layout-one of a single-family room (SFR) design and the other of an open bay area (OBA) design.DESIGN: Retrospective audit of more than 2000 patient days from each NICU cataloguing the differences in the number and duration of alarms for critical and alerting alarms, as well as the interaction of clinicians with the patient monitor.SETTING: Two level 3 NICUs.RESULTS: A total of more than 150 000 critical and 1.2 million alerting alarms were acquired from the two NICUs. The number of audible alarms and the associated noise pollution varied considerably with the OBA NICU generating 44{\%} more alarms per infant per day even though the SFR NICU generated 2.5 as many critical desaturation alarms per infant per day.CONCLUSION: Differences in the architectural layout of NICUs and the consequent differences in delays, thresholds and distribution systems for alarms are associated with differences in alarm pressure.",
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Does the architectural layout of a NICU affect alarm pressure? A comparative clinical audit of a single-family room and an open bay area NICU using a retrospective study design. / Joshi, Rohan; Straaten, Henrica Van; Mortel, Heidi Van De; Long, Xi; Andriessen, Peter; Pul, Carola Van.

In: BMJ open, Vol. 8, No. 6, e022813, 01.06.2018.

Research output: Contribution to journalArticleAcademicpeer-review

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AU - Straaten,Henrica Van

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AU - Long,Xi

AU - Andriessen,Peter

AU - Pul,Carola Van

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N2 - OBJECTIVES: To determine differences in alarm pressure between two otherwise comparable neonatal intensive care units (NICUs) differing in architectural layout-one of a single-family room (SFR) design and the other of an open bay area (OBA) design.DESIGN: Retrospective audit of more than 2000 patient days from each NICU cataloguing the differences in the number and duration of alarms for critical and alerting alarms, as well as the interaction of clinicians with the patient monitor.SETTING: Two level 3 NICUs.RESULTS: A total of more than 150 000 critical and 1.2 million alerting alarms were acquired from the two NICUs. The number of audible alarms and the associated noise pollution varied considerably with the OBA NICU generating 44% more alarms per infant per day even though the SFR NICU generated 2.5 as many critical desaturation alarms per infant per day.CONCLUSION: Differences in the architectural layout of NICUs and the consequent differences in delays, thresholds and distribution systems for alarms are associated with differences in alarm pressure.

AB - OBJECTIVES: To determine differences in alarm pressure between two otherwise comparable neonatal intensive care units (NICUs) differing in architectural layout-one of a single-family room (SFR) design and the other of an open bay area (OBA) design.DESIGN: Retrospective audit of more than 2000 patient days from each NICU cataloguing the differences in the number and duration of alarms for critical and alerting alarms, as well as the interaction of clinicians with the patient monitor.SETTING: Two level 3 NICUs.RESULTS: A total of more than 150 000 critical and 1.2 million alerting alarms were acquired from the two NICUs. The number of audible alarms and the associated noise pollution varied considerably with the OBA NICU generating 44% more alarms per infant per day even though the SFR NICU generated 2.5 as many critical desaturation alarms per infant per day.CONCLUSION: Differences in the architectural layout of NICUs and the consequent differences in delays, thresholds and distribution systems for alarms are associated with differences in alarm pressure.

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