Clinical Alarms in Intensive Care Units: Perceived Obstacles of Alarm Management and Alarm Fatigue in Nurses

Overview

Journal Healthc Inform Res

Date 2016 Feb 20

PMID 26893950

Citations 34

Authors

Ok Min Cho

Hwasoon Kim

Young Whee Lee

Insook Cho

Affiliations

Soon will be listed here.

Abstract

Objectives: The purpose of this descriptive study was to investigate the current situation of clinical alarms in intensive care unit (ICU), nurses' recognition of and fatigue in relation to clinical alarms, and obstacles in alarm management.

Methods: Subjects were ICU nurses and devices from 48 critically ill patient cases. Data were collected through direct observation of alarm occurrence and questionnaires that were completed by the ICU nurses. The observation time unit was one hour block. One bed out of 56 ICU beds was randomly assigned to each observation time unit.

Results: Overall 2,184 clinical alarms were counted for 48 hours of observation, and 45.5 clinical alarms occurred per hour per subject. Of these, 1,394 alarms (63.8%) were categorized as false alarms. The alarm fatigue score was 24.3 ± 4.0 out of 35. The highest scoring item was "always get bothered due to clinical alarms". The highest scoring item in obstacles was "frequent false alarms, which lead to reduced attention or response to alarms".

Conclusions: Nurses reported that they felt some fatigue due to clinical alarms, and false alarms were also obstacles to proper management. An appropriate hospital policy should be developed to reduce false alarms and nurses' alarm fatigue.

Citing Articles

Call for Decision Support for Electrocardiographic Alarm Administration Among Neonatal Intensive Care Unit Staff: Multicenter, Cross-Sectional Survey.

Tang X, Yang X, Yuan J, Yang J, Jin Q, Zhang H J Med Internet Res. 2024; 26():e60944.

PMID: 39705688 PMC: 11699503. DOI: 10.2196/60944.

Relationship Between Alarm Fatigue and Stress Among Acute Care Nurses: A Cross-Sectional Study.

Bani Hani S, Abu Aqoulah E SAGE Open Nurs. 2024; 10:23779608241292584.

PMID: 39493251 PMC: 11528618. DOI: 10.1177/23779608241292584.

Determinants of Intravenous Infusion Longevity and Infusion Failure via a Nonlinear Model Analysis of Smart Pump Event Logs: Retrospective Study.

Kia A, Waterson J, Bargary N, Rolt S, Burke K, Robertson J JMIR AI. 2024; 2:e48628.

PMID: 38875535 PMC: 11041480. DOI: 10.2196/48628.

Alarm fatigue and perceived stress among critical care nurses in the intensive care units: Palestinian perspectives.

Salameh B, Abdallah J, Alkubati S, ALBashtawy M BMC Nurs. 2024; 23(1):261.

PMID: 38654236 PMC: 11036661. DOI: 10.1186/s12912-024-01897-x.

Levels and Factors of Nurses' Alarm Fatigue in Critical Care Settings in Saudi Arabia: A Multicenter Cross-Sectional Study.

Alkubati S, Alsaqri S, Alrubaiee G, Almoliky M, Alqalah T, Pasay-An E J Multidiscip Healthc. 2024; 17:793-803.

PMID: 38410522 PMC: 10896094. DOI: 10.2147/JMDH.S452933.

References

Borycki E . Trends in health information technology safety: from technology-induced errors to current approaches for ensuring technology safety. Healthc Inform Res. 2013; 19(2):69-78. PMC: 3717440. DOI: 10.4258/hir.2013.19.2.69. View

Purbaugh T . Alarm fatigue: a roadmap for mitigating the cacophony of beeps. Dimens Crit Care Nurs. 2013; 33(1):4-7. DOI: 10.1097/DCC.0000000000000014. View

. Top 10 technology hazards for 2012. The risks that should be at the top of your prevention list. Health Devices. 2013; 40(11):358-73. View

. Hazard: Gorman-Rupp hypothermia machine. Health Devices. 1972; 1(8):190-1. View

Sendelbach S . Alarm fatigue. Nurs Clin North Am. 2012; 47(3):375-82. DOI: 10.1016/j.cnur.2012.05.009. View

Bell L . Monitor alarm fatigue. Am J Crit Care. 2010; 19(1):38. DOI: 10.4037/ajcc2010641. View

Edworthy J, Hellier E . Alarms and human behaviour: implications for medical alarms. Br J Anaesth. 2006; 97(1):12-7. DOI: 10.1093/bja/ael114. View

Momtahan K, Hetu R, Tansley B . Audibility and identification of auditory alarms in the operating room and intensive care unit. Ergonomics. 1993; 36(10):1159-76. DOI: 10.1080/00140139308967986. View

Cvach M, Biggs M, Rothwell K, Charles-Hudson C . Daily electrode change and effect on cardiac monitor alarms: an evidence-based practice approach. J Nurs Care Qual. 2012; 28(3):265-71. DOI: 10.1097/NCQ.0b013e31827993bc. View

10.

Inokuchi R, Sato H, Nanjo Y, Echigo M, Tanaka A, Ishii T . The proportion of clinically relevant alarms decreases as patient clinical severity decreases in intensive care units: a pilot study. BMJ Open. 2013; 3(9):e003354. PMC: 3773633. DOI: 10.1136/bmjopen-2013-003354. View

11.

Tsien C, Fackler J . Poor prognosis for existing monitors in the intensive care unit. Crit Care Med. 1997; 25(4):614-9. DOI: 10.1097/00003246-199704000-00010. View

12.

Gazarian P . Nurses' response to frequency and types of electrocardiography alarms in a non-critical care setting: a descriptive study. Int J Nurs Stud. 2013; 51(2):190-7. DOI: 10.1016/j.ijnurstu.2013.05.014. View

13.

Christensen M, Dodds A, Sauer J, Watts N . Alarm setting for the critically ill patient: a descriptive pilot survey of nurses' perceptions of current practice in an Australian Regional Critical Care Unit. Intensive Crit Care Nurs. 2014; 30(4):204-10. DOI: 10.1016/j.iccn.2014.02.003. View

14.

Funk M, Clark J, Bauld T, Ott J, Coss P . Attitudes and practices related to clinical alarms. Am J Crit Care. 2014; 23(3):e9-e18. DOI: 10.4037/ajcc2014315. View

15.

Bell L . Alarm fatigue linked to patient's death. Interview by Laura Wallis. Am J Nurs. 2010; 110(7):16. DOI: 10.1097/01.NAJ.0000383917.98063.bd. View

16.

Graham K, Cvach M . Monitor alarm fatigue: standardizing use of physiological monitors and decreasing nuisance alarms. Am J Crit Care. 2010; 19(1):28-34. DOI: 10.4037/ajcc2010651. View

17.

Borowski M, Gorges M, Fried R, Such O, Wrede C, Imhoff M . Medical device alarms. Biomed Tech (Berl). 2011; 56(2):73-83. DOI: 10.1515/BMT.2011.005. View

18.

. The hazards of alarm overload. Keeping excessive physiologic monitoring alarms from impeding care. Health Devices. 2007; 36(3):73-83. View

19.

Cvach M . Monitor alarm fatigue: an integrative review. Biomed Instrum Technol. 2012; 46(4):268-77. DOI: 10.2345/0899-8205-46.4.268. View