Intensive care unit nurses' perceptions and practices regarding clinical alarms: A descriptive study

doi:10.1002/nop2.1792

Observational Study

. 2023 Aug;10(8):5531-5540.

doi: 10.1002/nop2.1792. Epub 2023 Apr 26.

Intensive care unit nurses' perceptions and practices regarding clinical alarms: A descriptive study

Lei Wang¹, Wei He², Yulu Chen³, Qiuping Wu⁴, Xin Du⁵, Qin Li⁶, Caiping Song⁷

Affiliations

¹ Department of Orthopedics, The Second Affiliated Hospital of Army Medical University, Chongqing, China.
² Department of Gastroenterology, The Second Affiliated Hospital of Army Medical University, Chongqing, China.
³ Department of Otolaryngology, The Second Affiliated Hospital of Army Medical University, Chongqing, China.
⁴ Department of Cardiology, The Second Affiliated Hospital of Army Medical University, Chongqing, China.
⁵ Department of Hematology, The Second Affiliated Hospital of Army Medical University, Chongqing, China.
⁶ Department of Neurology, The Second Affiliated Hospital of Army Medical University, Chongqing, China.
⁷ President Office, The Second Affiliated Hospital of Army Medical University, Chongqing, China.

PMID: 37101342
PMCID: PMC10333838
DOI: 10.1002/nop2.1792

Observational Study

Intensive care unit nurses' perceptions and practices regarding clinical alarms: A descriptive study

Lei Wang et al. Nurs Open. 2023 Aug.

. 2023 Aug;10(8):5531-5540.

doi: 10.1002/nop2.1792. Epub 2023 Apr 26.

Authors

Lei Wang¹, Wei He², Yulu Chen³, Qiuping Wu⁴, Xin Du⁵, Qin Li⁶, Caiping Song⁷

Affiliations

¹ Department of Orthopedics, The Second Affiliated Hospital of Army Medical University, Chongqing, China.
² Department of Gastroenterology, The Second Affiliated Hospital of Army Medical University, Chongqing, China.
³ Department of Otolaryngology, The Second Affiliated Hospital of Army Medical University, Chongqing, China.
⁴ Department of Cardiology, The Second Affiliated Hospital of Army Medical University, Chongqing, China.
⁵ Department of Hematology, The Second Affiliated Hospital of Army Medical University, Chongqing, China.
⁶ Department of Neurology, The Second Affiliated Hospital of Army Medical University, Chongqing, China.
⁷ President Office, The Second Affiliated Hospital of Army Medical University, Chongqing, China.

PMID: 37101342
PMCID: PMC10333838
DOI: 10.1002/nop2.1792

Abstract

Aim: To describe the frequencies of physiologic monitor clinical alarms and to investigate nurses' perceptions and practices regarding clinical alarms in ICUs.

Design: A descriptive study.

Methods: A 24-h continuous nonparticipant observation study was conducted in ICU. Observers observed and recorded the occurrence time, detail information when electrocardiogram monitor alarms triggered. And a cross-sectional study was conducted among ICU nurses by convenience sampling, using the general information questionnaire and the Chinese version of clinical alarms survey questionnaire for medical devices. Data analysis was performed using SPSS 23.

Results: A total of 13,829 physiologic monitor clinical alarms were recorded in 14-day observation and 1191 ICU nurses responded to the survey. Most nurses agreed or strongly agreed the sensitivity to alarms and responded quickly (81.28%), smart alarm systems (74.56%), alarm notification systems (72.04%) and set up alarm administrators (59.45%) were useful to improve alarm management, while frequent nuisance alarms disrupted patients care (62.47%) and reduced nurses' trust in alarms (49.03%), environmental noise interfered with nurses' recognition of the alarms (49.12%) and not everyone received education of alarm systems (64.65%).

Conclusions: Physiological monitor alarms occur frequently in ICU, and it is necessary to formulate or further optimize alarm management measures. It is recommended to use smart medical devices and alarm notification systems, formulate and implement standardized alarm management policies and norms, and strengthen alarm management education and training, so as to improve the nursing quality and patient safety.

Patient or public contribution: The patients in the observation study included all patients admitted to the ICU during the observation period. The nurses in the survey study were conveniently selected through an online survey.

Keywords: alarm management; clinical alarm; intensive care unit; nurse; patient safety; physiological monitor.

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Conflict of interest statement

The authors declare no conflict of interest.

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References

1. Akturan, S. , Güner, Y. , Tuncel, B. , Üçüncüoğlu, M. , & Kurt, T. (2022). Evaluation of alarm fatigue of nurses working in the COVID‐19 intensive care service: A mixed methods study. Journal of Clinical Nursing, 31, 2654–2662. 10.1111/jocn.16190 - DOI - PubMed
1. Andrade‐Méndez, B. , Arias‐Torres, D. O. , & Gómez‐Tovar, L. O. (2020). Alarm fatigue in the intensive care unit: Relevance and response time. Enferm Intensiva (Engl Ed), 31(3), 147–153. 10.1016/j.enfi.2019.11.002 - DOI - PubMed
1. Berglund, B. , Lindvall, T. , & Schwela, D. H. (2000). New WHO guidelines for community noise. Noise & Vibration Worldwide, 31(4), 24–29.
1. Bi, J. , Yin, X. , Li, H. , Gao, R. , Zhang, Q. , Zhong, T. , Zan, T. , Guan, B. , & Li, Z. (2020). Effects of monitor alarm management training on nurses' alarm fatigue: A randomised controlled trial. Journal of Clinical Nursing, 29(21–22), 4203–4216. 10.1111/jocn.15452 - DOI - PubMed
1. Bridi, A. C. , da Silva, R. C. L. , de Farias, C. C. P. , Franco, A. S. , & dos Santos, V. D. L. Q. (2014). Reaction time of a health care team to monitoring alarms in the intensive care unit: implications for the safety of seriously ill patients. Revista Brasileira de Terapia Intensiva, 26, 28–35. - PMC - PubMed

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[1] Akturan, S. , Güner, Y. , Tuncel, B. , Üçüncüoğlu, M. , & Kurt, T. (2022). Evaluation of alarm fatigue of nurses working in the COVID‐19 intensive care service: A mixed methods study. Journal of Clinical Nursing, 31, 2654–2662. 10.1111/jocn.16190 - DOI - PubMed

[2] Akturan, S. , Güner, Y. , Tuncel, B. , Üçüncüoğlu, M. , & Kurt, T. (2022). Evaluation of alarm fatigue of nurses working in the COVID‐19 intensive care service: A mixed methods study. Journal of Clinical Nursing, 31, 2654–2662. 10.1111/jocn.16190 - DOI - PubMed

[3] Andrade‐Méndez, B. , Arias‐Torres, D. O. , & Gómez‐Tovar, L. O. (2020). Alarm fatigue in the intensive care unit: Relevance and response time. Enferm Intensiva (Engl Ed), 31(3), 147–153. 10.1016/j.enfi.2019.11.002 - DOI - PubMed

[4] Andrade‐Méndez, B. , Arias‐Torres, D. O. , & Gómez‐Tovar, L. O. (2020). Alarm fatigue in the intensive care unit: Relevance and response time. Enferm Intensiva (Engl Ed), 31(3), 147–153. 10.1016/j.enfi.2019.11.002 - DOI - PubMed

[5] Berglund, B. , Lindvall, T. , & Schwela, D. H. (2000). New WHO guidelines for community noise. Noise & Vibration Worldwide, 31(4), 24–29.

[6] Berglund, B. , Lindvall, T. , & Schwela, D. H. (2000). New WHO guidelines for community noise. Noise & Vibration Worldwide, 31(4), 24–29.

[7] Bi, J. , Yin, X. , Li, H. , Gao, R. , Zhang, Q. , Zhong, T. , Zan, T. , Guan, B. , & Li, Z. (2020). Effects of monitor alarm management training on nurses' alarm fatigue: A randomised controlled trial. Journal of Clinical Nursing, 29(21–22), 4203–4216. 10.1111/jocn.15452 - DOI - PubMed

[8] Bi, J. , Yin, X. , Li, H. , Gao, R. , Zhang, Q. , Zhong, T. , Zan, T. , Guan, B. , & Li, Z. (2020). Effects of monitor alarm management training on nurses' alarm fatigue: A randomised controlled trial. Journal of Clinical Nursing, 29(21–22), 4203–4216. 10.1111/jocn.15452 - DOI - PubMed

[9] Bridi, A. C. , da Silva, R. C. L. , de Farias, C. C. P. , Franco, A. S. , & dos Santos, V. D. L. Q. (2014). Reaction time of a health care team to monitoring alarms in the intensive care unit: implications for the safety of seriously ill patients. Revista Brasileira de Terapia Intensiva, 26, 28–35. - PMC - PubMed

[10] Bridi, A. C. , da Silva, R. C. L. , de Farias, C. C. P. , Franco, A. S. , & dos Santos, V. D. L. Q. (2014). Reaction time of a health care team to monitoring alarms in the intensive care unit: implications for the safety of seriously ill patients. Revista Brasileira de Terapia Intensiva, 26, 28–35. - PMC - PubMed

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Intensive care unit nurses' perceptions and practices regarding clinical alarms: A descriptive study

Affiliations

Intensive care unit nurses' perceptions and practices regarding clinical alarms: A descriptive study

Authors

Affiliations

Abstract

Conflict of interest statement

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References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources