New Article Showcases an Effective Surveillance System for General Care Units Using Masimo Patient SafetyNet™
Masimo Patient SafetyNet was first implemented in the 36-bed orthopedic
unit at D-H in
Much of the initiative’s success is due to D-H’s development of a robust general care alarm management strategy, including the implementation of Masimo SET® Measure-through Motion and Low Perfusion™ pulse oximetry. As the authors note, “device-level characteristics such as measurement reliability and alarm annunciation” are critical. A systematic approach to alarm management is needed because of the growing problem of “‘alarm fatigue’ – the growing desensitization of health care providers to alarms” as a result of the “growing number of monitoring devices, combined with suboptimal patient monitoring and alarm management strategies.” False and/or nonactionable alarms may occur as much as 90% of the time, according to one study5; another, involving the Philips HP Merlin M1094 monitor, found that 77% were either not recognized or ignored6; a third, involving Nellcor pulse oximetry, found an actual risk for patients in only 3% of alarm states, and that anesthesiologists have been shown to disable alarms because of high false alarm rates.7
D-H attempted to optimize several key elements of an effective alarm management strategy: 1) static alarm settings – setting thresholds based on patient groups to reduce nuisance alarms; 2) alarm delays – introducing a delay of 15 seconds before an alarm sounds, as “Many changes in physiologic parameters are brief and self-correcting”; 3) alarm threshold adjustments – adapting to “physiologic variation among different patients” by adjusting alarms based on a three-tiered system of the static defaults, independent nurse adjustments, and provider-ordered individualized settings; and 4) alarm announcement – having the alarm sent to the nurse in charge of the patient via remote pager and allowing customization of when and how alarms are escalated to additional clinicians, by which practice alarm exposure has now been reduced by almost 90%.
Important to the success of the D-H alarm management strategy was the
selection of Masimo SET® and Patient SafetyNet architecture,
as part of D-H’s patient surveillance system. As the authors note, a
fundamental factor affecting operation of and response to clinical
monitor alarms is “device-level characteristics such as measurement
reliability and alarm annunciation.” As the initiative’s
centrally-monitored parameter they notably chose oxygen saturation (SpO2),
measured using Masimo SET® pulse oximetry, which has been
shown to reduce false alarms by over 95% and increase true alarm
detection to over 97%, even during motion and low perfusion.8
Regarding the choice of remote monitoring system, the authors note that
“A previously installed multiparameter monitoring system on the
pediatric unit was largely rejected by the staff because of alarm system
issues, such as high false alarm rates, lack of directed notification,
and ambiguous alarm indicators. The alarm rate [with
“Dartmouth-Hitchcock provides a compelling example of the benefits that
a robust patient monitoring and surveillance system, coupled with a
carefully executed strategy, can reap,” said
@MasimoInnovates | #Masimo
McGrath, S.P., Taenzer, A.H., Karon, N, Blike, G. “Surveillance
Monitoring Management for General Care Units: Strategy, Design, and
The Joint Commission Journal on Quality and Patient Safety. 2016 Jul;42(7):293-302.
- All published clinical studies on Masimo products can be found at http://www.masimo.com/cpub/clinical-evidence.htm.
- Taenzer A.H., Pyke J.B., McGrath S.P., Blike G.T. Anesthesiology. 2010 Feb;112(2):282-7.
- Taenzer A, Blike G, McGrath S, Pyke J, Herrick M, Renaud C, Morgan J. "Postoperative Monitoring - The Dartmouth Experience." Anesthesia Patient Safety Foundation Newsletter Spring-Summer 2012. Available online.
- Imhoff M, Kuhls S. Alarm algorithms in critical care monitoring. Anesth Analg. 2006;102:1525-1537.
- Gorges M, et al. Improving alarm performance in the medical intensive care unit using delays and clinical context. Anesth Analg. 2009;108:1546-1552.
Kestin IG, Miller BR,
Lockhart CH. Auditoryalarms during anesthesia monitoring. Anesthesiology. 1988;69:106-109.
- Shah N et al. J Clin Anesth 2012 Aug;24(5):385-91.
HealthGrades Quality Study. Patient Safety in American Hospitals (
*The use of the trademark SafetyNet is under license from
Masimo (NASDAQ:MASI) is a global leader in innovative noninvasive monitoring technologies. Our mission is to improve patient outcomes and reduce the cost of care by taking noninvasive monitoring to new sites and applications. In 1995, the company debuted Masimo SET® Measure-through Motion and Low Perfusion™ pulse oximetry, which has been shown in multiple studies to significantly reduce false alarms and accurately monitor for true alarms. Masimo SET® is estimated to be used on more than 100 million patients in leading hospitals and other healthcare settings around the world. In 2005, Masimo introduced rainbow® Pulse CO-Oximetry technology, allowing noninvasive and continuous monitoring of blood constituents that previously could only be measured invasively, including total hemoglobin (SpHb®), oxygen content (SpOC™), carboxyhemoglobin (SpCO®), methemoglobin (SpMet®), and more recently, Pleth Variability Index (PVI®) and Oxygen Reserve Index (ORI™), in addition to SpO2, pulse rate, and perfusion index (PI). In 2014, Masimo introduced Root®, an intuitive patient monitoring and connectivity platform with the Masimo Open Connect™ (MOC-9™) interface. Masimo is also taking an active leadership role in mHealth with products such as the Radius-7™ wearable patient monitor and the MightySat™ fingertip pulse oximeter. Additional information about Masimo and its products may be found at www.masimo.com. All published clinical studies on Masimo products can be found at http://www.masimo.com/cpub/clinical-evidence.htm.
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Section 27A of the Securities Act of 1933 and Section 21E of the
Securities Exchange Act of 1934, in connection with the Private
Securities Litigation Reform Act of 1995. These forward-looking
statements include, among others, statements regarding the potential
effectiveness of Masimo Patient SafetyNet™. These forward-looking
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affecting us and are subject to risks and uncertainties, all of which
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could cause our actual results to differ materially and adversely from
those expressed in our forward-looking statements as a result of various
risk factors, including, but not limited to: risks related to our
assumptions regarding the repeatability of clinical results; risks
related to our belief that Masimo's unique noninvasive measurement
technologies, including Masimo Patient SafetyNet, contribute to positive
clinical outcomes and patient safety; risks related to our belief that
Masimo noninvasive medical breakthroughs provide cost-effective
solutions with comparable accuracy and unique advantages, including:
immediate and continuous results that enable earlier treatment without
causing invasive trauma in all patients and in every clinical situation;
as well as other factors discussed in the "Risk Factors" section of our
most recent reports filed with the
Evan Lamb, 949-396-3376