According to The Joint Commission (TJC), 98 unexpected and unacceptable events related to alarm fatigue were reported in United States hospitals between January 2009 and June 2012. There were 80 deaths, 13 permanent loss of function, and 5 extended care stays that occurred during this time period. The problem identified in this quality improvement (QI) initiative was the TJC report that nursing staff in the US was experiencing alarm fatigue due to the overstimulation of senses from continuous beeping from alarms on the unit. Framed within the Iowa model of evidence-based practice to promote quality care, the purpose of the project was to develop a patient care alarm fatigue initiative as mandated by TJC including a policy and procedure for managing alarm fatigue, a curriculum plan for educating the nursing staff on alarm fatigue, and a survey on nurse attitudes toward alarm fatigue to be administered at the beginning of the education. The developed policy and procedure was approved by the committee with the recommendation to revise the policy to involve all ancillary staff in direct contact with clinical alarms. The curriculum objectives were evaluated by 2 content experts using a 4 item met/not met response format. Findings showed that all objectives were met. The content of the nurse survey was reviewed by the experts using a 3 item Likert scale and all the items were deemed relevant. Finally, team members (n = 9) completed a summative evaluation of the project using an 8 item, 5-option Likert scale. All were in agreement that the project met its intent. The implementation of this project after graduation has the potential to bring about social change by increasing patient safety, patient well being and reducing healthcare costs.

More than 13,000 deaths and $340 million in health care costs are the result of catheter-associated urinary tract infections (CAUTIs) annually in the United States. CAUTIs can also result in acute patient discomfort and potentially preventable exposure to antibiotics. The hospital for which this quality improvement project was developed was above the National Healthcare Safety Network CAUTI bench mark. Framed within the Iowa model of evidence-based practice, a multidisciplinary team of 8 hospital stakeholders guided the project (n=8). The purpose of the project was to develop an indwelling urinary catheter maintenance checklist using evidence-based practice guidelines related to preexisting inappropriate risk factors for catheterization and appropriate indications for catheterization, as well as evidence-based maintenance practices for care of the indwelling catheter. Each piece of evidence to be included in the checklist was evaluated by 4 content experts using a 10 item 5 point Likert scale ranging from 'strongly disagree' to 'strongly agree'. Descriptive analysis showed an average of 4.8/5 for all items with 'agree' being voiced in two of the items rather than 'strongly agree'. The checklist was completed and presented to hospital senior leadership who recommended that the checklist be incorporated into the hospital CAUTI prevention plan. All project team members (n=8) completed an 8 item 5 point Likert scale summative evaluation of the purpose, goal, objectives, and my leadership which averaged as 5 or 'strongly agree' supporting the development of the project. Implications for social change include improved patient outcomes, mindful stewardship of healthcare dollars, and increased patient and family satisfaction.