The risks associated with clinical alarms threaten the hospital environment. “566 deaths related to monitoring alarms” were reported from a separate Manufacturer and User Facility Device Experience (MAUDE) database (Cvach, 2012, p. 269). Pelletier (2013) reported that one of the major factors contributing to patient deaths was related to “alarm fatigue” (p. 292). The purpose of this document is to review research and explore best practices to support alarm management and prevent alarm fatigue and patient harm. Welch (2012) reported that nurses compared patient care areas to those of a “carnival or casino” (p. 1). Edworthy (2013) found that in clinical telemetry settings the presence of false alarm rates was “unacceptably high” and “the correct application of auditory alarm principles was compromised” (p. 1). According to the American College of Clinical Engineering (ACCE) Healthcare Technology Foundation (2011), alarm fatigue occurs when “too many alarms occur in a clinical environment” (p. 1). When faced with hundreds of alarms in a day of patient care, “5% represents a true clinical intervention required” (American College of Clinical Engineering (ACCE) Healthcare Technology Foundation, 2007). The Joint Commission recognized the urgency by addressing the security of warning systems. In the April 2013 Sentinel Event Alert, the Joint Commission reported 98 alert-related events (JACHO, 2103). Of these 98 events, 80 lead to death and 13 resulted in permanent loss of function (JACHO, 2103). A new patient safety goal for 2014 is to improve the safety of clinical alarms. Performance elements include prioritizing alarm management. This includes establishing policies and procedures for managing… half of the document… Orthy (2012) completed a narrative review. This article was not classified as systematic or integrative, although the research was comprehensive. Edworthy (2012) completed a review that includes many of the traditional medical literature databases such as PubMed and Web of Knowledge. He also researched the journals PsychINFO and Human Factor. His strategy was to review available research specifically on response time to auditory alarms. Fifty-eight articles were cited in this review. This article represents a comprehensive narration from an expert in the specialized area. The author has twenty-five years of experience as a researcher and designer in the field of audible alarms. His findings suggest a significant improvement in alarm response when greater emphasis is placed on the design of the alarm (Edworthy, 2012). He recommended standardization of alarms.