Differences in Alarm Events between Disposable And

Background Disposable electrocardiographic lead wires (ECG-LWs) may not be as durable as reusable ones. Objective To examine differences in alarm events between disposable and reusable ECG-LWs. Method Two cardiac telemetry units were randomized to reusable ECG-LWs, and 2 units alternated between disposable and reusable ECG-LWs for 4 months. A remote monitoring team, blinded to ECG-LW type, assessed frequency and type of alarm events by using total counts and rates per 100 patient days. Event rates were compared by using generalized linear mixed-effect models for differences and noninferiority between wire types. Results In 1611 patients and 9385.5 patient days of ECG monitoring, patient characteristics were similar between groups. Rates of alarms for no telemetry, leads fail, or leads off were lower in disposable ECG-LWs (adjusted relative risk [95% CI], 0.71 [0.53-0.96]; noninferiority P< .001; superiority P= .03) and monitoring (artifact) alarms were significantly noninferior (adjusted relative risk [95% CI]: 0.88, [0.62-1.24], P= .02; superiority P= .44). No between-group differences existed in false or true crisis alarms. Disposable ECG-LWs were noninferior to reusable ECGLWs for all false-alarm events (N [rate per 100 patient days], disposable 2029 [79.1] vs reusable 6673 [97.9]; adjusted relative risk [95% CI]: 0.81 [0.63-1.06], P = .002; superiority P= .12.) Conclusions Disposable ECG-LWs with patented push-button design had superior performance in reducing alarms created by no telemetry, leads fail, or leads off and significant noninferiority in all false-alarm rates compared with reusable ECG-LWs. Fewer ECG alarms may save nurses time, decrease alarm fatigue, and improve patient safety. (American Journal of Critical Care. 2015; 24:67-74) DIFFERENCES IN ALARM EVENTS BETWEEN DISPOSABLE AND REUSABLE ELECTROCARDIOGRAPHY LEAD WIRES