# Smart Intravenous Infusion Dosing System
## 2 State of the Art
### Medical Staff Response Time to Alarms  
The last subsection presents the response time of medical staff to alarms (for different scenarios) in order to obtain feedback from patients on the response speed of medical staff, which greatly affects patient satisfaction.  
An analysis of the response time of medical staff using a stopwatch and surveying a total of 30 patients at the Indonesian National Hospital is presented in [45]. The response time of medical staff is within the legitimate values, with female patients being more satisfied with the service (in terms of response time) than male patients. An analysis of the response time of medical staff in monitoring pulse oximetry in a total of 103 patients is presented in [46]. When any of the oxygen parameters is outside the allowable values, a green light alarm is activated in front of the patient's room. The medical staff on duty have 15 s to react to that alarm, otherwise a flashing green light in front of the patient's room and an audible alarm in the monitoring room are activated for another medical worker to react. If the staff does not react even after 3 min and 15 s, an emergency alarm is activated in the medical staff room--a louder alarm of stronger intensity and a flashing green and white light in front of the patient's room. As many as 26% of missed initial alarms were recorded--40% of missed alarms generated after 2 min and 27% of missed alarms generated after 3 min. An analysis of the response time of medical staff to light alarms in four nursing homes is presented in [47]. There were light signals in front of each patient's room, where the red light indicates that the patient needs help in the bathroom, while the white light indicates the necessary help when moving in the room. Due to frequent alarms, the response time was outside the defined standards, while in as many as 50% of cases, the staff responded only after 5 min. According to [48], the medical staff diminish the importance of light alarms, especially when the patient is not endangered, and therefore either do not respond to light alarms or react very slowly. An analysis of alarm response time via video recordings of patients connected to ventilators in a children'shospital is presented in [49]. Each of the 36 nurses was assigned two or four patients, resulting in a total of 5070 on-call alarms. With the increase in the number of alarms that do not require an urgent response, the response time of nurses has increased significantly. A study which analyzed the response time of medical staff in the emergency department using a questionnaire completed by the patients found that they considered the response time of the medical staff to be unsatisfactory [50]. An analysis of nurses' response times to patient calls by canceling alarms is presented in [51]. In this experiment, after deactivation of the existing alarms in the department, each nurse was assigned one patient per day. With frequent changes of nurses and the exchange of key information about patients during short team meetings, the response time of nurses has decreased, but with the importance of engagement and effort of nurses, which is impossible for a longer period and a larger number of patients.