Are melodic medical equipment alarms easily learned?

Anesth Analg. 2008 Feb;106(2):501-8, table of contents. doi: 10.1213/01.ane.0000286148.58823.6c.

Abstract

Background: We tested melodic auditory alarms recommended in the IEC 60601-1-8 standard for medical electrical equipment for ease of learning and discrimination, and for effectiveness during a timeshared task.

Methods: Twenty-two critical care nurses learned the IEC 60601-1-8 melodic alarms over two training sessions more than a week apart, with or without mnemonics suggested in the standard. Subsequently, the nurses identified alarms arriving at quasi random intervals while performing a timeshared arithmetic task.

Results: Only one nurse (4.5%) identified the alarms with 100% accuracy after two training sessions. Mnemonics did not improve overall alarm identification accuracy (mnemonic = 56%, nonmnemonic = 55%) but led to a narrower range of confusions between alarms. Nurses responded faster (P < 0.0001) and more accurately (P = 0.032) to medium priority than high priority alarms, despite rating high priority alarms as sounding more urgent (P < 0.0001). Nurses with at least 1 yr of formal musical training identified the alarms much more accurately (musical training = 73%, no musical training = 38%, P < 0.0001), perceived a greater distinction between high and medium priority alarms (P = 0.002), and found identifying the alarms easier overall (P = 0.023). During the timeshared task, nurses' responses were slower (P = 0.002) and became less accurate (P = 0.02).

Conclusions: The slow rate of learning and persistent confusions suggest that the IEC 60601-1-8 melodic alarms should be redesigned before they are adopted for clinical practice.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acoustic Stimulation / methods*
  • Adult
  • Critical Care / methods
  • Discrimination Learning* / physiology
  • Durable Medical Equipment* / standards
  • Equipment Failure
  • Female
  • Humans
  • Male
  • Memory / physiology
  • Middle Aged
  • Music*
  • Nursing Staff / standards
  • Random Allocation
  • Reaction Time / physiology
  • Time Factors