Changes in default alarm settings and standard in-service are insufficient to improve alarm fatigue in an intensive care unit: a pilot project(1111 Sowan AK, Gomez TM, Tarriela AF, Reed CC, Paper BM. Changes in default alarm settings and standard in-service are insufficient to improve alarm fatigue in an intensive care unit: a pilot project. JMIR Hum Factors [Internet]. 2016[cited 2014 Dec 18];3(1):e1. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4797663/pdf/humanfactors_v3i1e1.pdf
https://www.ncbi.nlm.nih.gov/pmc/article...
)
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2016USA |
Qualitative study 39 nurses |
Alteration of 17 parameters in default alarms of cardiac monitors |
Altering the setting of default alarms and training in standard procedures for use of cardiac monitors is not enough to improve the safety of alarm systems. |
Nurses’ perspectives on clinical alarms(1212 Honan L, Funk M, Maynard M, Fahs D, Clark T, David Y. Nurses’ perspectives on clinical alarms. Am J Crit Care [Internet]. 2015[cited 2014 Dec 18];24(5):387-95. Available from: http://ajcc.aacnjournals.org/content/24/5/387.long
http://ajcc.aacnjournals.org/content/24/...
)
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2015USA |
Qualitative study406 nurses |
The Krippendorff method for content analysis was used to analyze 790 comments on the perception of clinical alarms by 406 nurses. |
Nurses are concerned about the impact of fatigue on nurses and patients caused by alarms. They recognize the importance of their role in the reduction of noise pollution and indicate some strategies that might lessen false alarms. |
Attitudes and practices related to clinical alarms(1313 Funk M, Clark JT, Bauld TJ, Ott JC, Coss P. Attitudes and practices related to clinical alarms. Am J Crit Care [Internet]. 2014[cited 2014 Dec 18];23(3):e9-e18. Available from: http://ajcc.aacnjournals.org/content/23/3/e9.long
http://ajcc.aacnjournals.org/content/23/...
)
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2014USA |
Quantitative study2005-20061327 responses2011 4278 responses |
To determine if practices and behaviors regarding clinical alarms have changed over time, by comparing results of studies conducted by the Healthcare Technology Foundation (HTF) in 2005-2006 and 2011. |
The safety of clinical alarms has been a constant challenge and has received significant attention in recent years; however, slow measurable progress has been observed since 2005-2006, when the first study associated with this phenomenon was conducted. False alarms still contribute toward the noisy environment in hospitals. Sentinel events and fatigue to alarms reported in the first study remain. |
Nurses’ response to frequency and types of electrocardiography alarms in a non-critical care setting: a descriptive study(1414 Gazarian PK. Nurses’ response to frequency and types of electrocardiography alarms in a non-critical care setting: a descriptive study. Int J Nurs Stud [Internet]. 2014[cited 2014 Dec 18];51(2):190-7. Available from: http://www.journalofnursingstudies.com/article/S0020-7489(13)00157-0/abstract
http://www.journalofnursingstudies.com/a...
)
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2014USA |
Observational, descriptive, and prospective studyNurses (n=9) |
To describe routines associated with practices of nurses regarding the continuous monitoring of ECGs, types and frequencies of alarms, nursing interventions triggered, and their impact on care plan for patients. |
Nurses responded to 46.8% of alarms. Routine practices related to monitoring still show gaps in the management of alarms. Comments also showed difficulty and complexity in managing alarm systems. |
Reducing hospital noise: a review of medical device alarm management(1515 Konkani A, Oakley B, Bauld TJ. Reducing hospital noise: a review of medical device alarm management. Biomed Instrum Technol [Internet]. 2012[cited 2014 Dec 18];46(6):478-87. Available from: http://www.aami-bit.org/doi/pdf/10.2345/0899-8205-46.6.478
http://www.aami-bit.org/doi/pdf/10.2345/...
)
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2012USA |
Systematic literature review27 articles |
To identify practices that might reduce the number of false clinical alarms, in order to increase patient safety and provide a more peaceful environment for patients and professionals. |
The main problems associated with clinical alarms were: the high number of false alarms; inaudibility of alarms due to the competition of sounds; difficulty in distinguishing the urgency of alarms; and the increase in noise caused by the raise in the number of alarms. The effects caused are: the increase in noise level, increase in irritability of patients and professionals, reduction in credibility of alarms systems, increase in response time to alarms, reduction in patient safety and professionals’ performance, and increase in the number of adverse events. |
| Monitor alarm fatigue – an integrative review(33 Cvach M. Monitor alarm fatigue: an integrative review. Biomed Instrum Technol. 2012 Jul-Aug;46(4):268-77.)
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2012USA |
Integrative review 72 articles |
To determine if the amount of noise interferes with the response of nurses to alarms of cardiac monitors. |
The results of the study were organized in 5 topics:1) Excessive alarms and their effects on professionals; 2) Response of nurses to alarms - perceiving the urgency of alarms contributes to responses of nurses; 3) Sound of alarms and audibility - noise contributes to the stress of professionals and symptoms such as fatigue, problems with concentration and migraines from tension; 4) Technology to reduce false alarms; 5) Alarm notification system – wireless technologies might be a viable alternative to human monitoring. |
Sound intensity and noise evaluation in critical care unit(1616 Lawson N, Thompson K, Saunders G, Saiz J, Richardson J, Brown D, et al. Sound intensity and noise evaluation in a critical care unit. Am J Crit Care [Internet]. 2010[cited 2014 Dec 18];19(6):e88-98. Available from: http://ajcc.aacnjournals.org/content/19/6/e88
http://ajcc.aacnjournals.org/content/19/...
)
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2010USA |
Quantitative studyn=12 |
To measure the noise level to which patients are exposed in intensive care units. |
Noise peaks of alarms inside patients’ rooms are high and increased as the setting of alarm levels increased.Levels of these alarms, when measured in adjacent rooms, did not increase with the increase in alarm levels. The average noise level inside patients’ rooms was mostly lower than 45 dB, but noise peaks were always higher than 85 dB. Closing the door of adjacent rooms did not reduce noise peaks. Peaks and the average noise levels did not differ systematically during 24 hours of measurement. |
A national online survey on the effectiveness of clinical alarms(99 Korniewicz DM, Clark T, David Y. A national online survey on the effectiveness of clinical alarms. Am J Crit Care [Internet]. 2008[cited 2014 Dec 18];17(1):36-41. Available from: http://ajcc.aacnjournals.org/content/17/1/36.long
http://ajcc.aacnjournals.org/content/17/...
)
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2008USA |
Quantitative study1327 participants51% nurses (n=676)49% other healthcare professionals (n=651) |
To determine problems associated with clinical alarms in a hospital context. |
The effective management of clinical alarms depends on the equipment design, professionals (an active role in learning the use of all functions of the equipment), and hospitals (need to recognize the complexity of managing alarms and provide the required resources for the development of effective management systems). |
