Alarm setting for the critically ill patient: a descriptive pilot survey of nurses' perceptions of current practice in an Australian Regional Critical Care Unit

Martin Christensen; Andrew Dodds; Josh Sauer; Nigel Watts

doi:10.1016/j.iccn.2014.02.003

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 Aug;30(4):204-10. doi: 10.1016/j.iccn.2014.02.003. Epub 2014 Apr 3.

Authors

Martin Christensen¹, Andrew Dodds², Josh Sauer², Nigel Watts²

Affiliations

¹ School of Health & Human Science, Southern Cross University, Rifle Range Road, Lismore, NSW 2480, Australia. Electronic address: martin.christensen@scu.edu.au.
² Intensive Care Unit, Lismore Base Hospital, Lismore, NSW 2480, Australia.

PMID: 24703797
DOI: 10.1016/j.iccn.2014.02.003

Abstract

Aim: The aim of this survey was to assess registered nurse's perceptions of alarm setting and management in an Australian Regional Critical Care Unit.

Background: The setting and management of alarms within the critical care environment is one of the key responsibilities of the nurse in this area. However, with up to 99% of alarms potentially being false-positives it is easy for the nurse to become desensitised or fatigued by incessant alarms; in some cases up to 400 per patient per day. Inadvertently ignoring, silencing or disabling alarms can have deleterious implications for the patient and nurse.

Method: A total population sample of 48 nursing staff from a 13 bedded ICU/HDU/CCU within regional Australia were asked to participate. A 10 item open-ended and multiple choice questionnaire was distributed to determine their perceptions and attitudes of alarm setting and management within this clinical area.

Results: Two key themes were identified from the open-ended questions: attitudes towards inappropriate alarm settings and annoyance at delayed responses to alarms. A significant number of respondents (93%) agreed that alarm fatigue can result in alarm desensitisation and the disabling of alarms, whilst 81% suggested the key factors are those associated with false-positive alarms and inappropriately set alarms.

Conclusion: This study contributes to what is known about alarm fatigue, setting and management within a critical care environment. In addition it gives an insight as to what nurses' within a regional context consider the key factors which contribute to alarm fatigue. Clearly nursing burnout and potential patient harm are important considerations for practice especially when confronted with alarm fatigue and desensitisation. Therefore, promoting and maintaining an environment of ongoing intra-professional communication and alarm surveillance are crucial in alleviating these potential problems.

Keywords: Alarm desensitisation; Alarm fatigue; False alarms; Nuisance alarms.

MeSH terms

Attitude of Health Personnel
Auditory Fatigue*
Australia
Clinical Alarms*
Critical Care / methods*
Critical Care / psychology*
Critical Illness / nursing*
Humans
Monitoring, Physiologic / instrumentation*
Nursing Staff, Hospital / psychology*
Pilot Projects
Surveys and Questionnaires
United Kingdom