Estimation of the patient monitor alarm rate for a quantitative analysis of new alarm settings

In many critical care units, default patient monitor alarm settings are not fine-tuned to the vital signs of the patient population. As a consequence there are many alarms. A large fraction of the alarms are not clinically actionable, thus contributing to alarm fatigue. Recent attention to this phenomenon has resulted in attempts in many institutions to decrease the overall alarm load of clinicians by altering the trigger thresholds for monitored parameters. Typically, new alarm settings are defined based on clinical knowledge and patient population norms and tried empirically on new patients without quantitative knowledge about the potential impact of these new settings. We introduce alarm regeneration as a method to estimate the alarm rate of new alarm settings using recorded patient monitor data. This method enables evaluation of several alarm setting scenarios prior to using these settings in the clinical setting. An expression for the alarm rate variance is derived for the calculation of statistical confidence intervals on the results.