Nursing 1100 (Fundamentals)

Published for Joint Commission accredited organizations and interested health care professionals.

Alarm fatigue occurs when clinicians experience high exposure to medical device alarms, causing alarm desensitization and leading to missed alarms or delayed response. As the frequency of alarms used in healthcare rises, alarm fatigue has been increasingly recognized as an important patient safety issue.

Alarm fatigue is a widely acknowledged patient safety concern in hospitals. In 2013, The Joint Commission issued a National Patient Safety Goal on Alarm Management, making addressing alarm manage-ment a priority. To capture changes in attitudes and practices related to alarms, the Healthcare Technology Foundation conducted and reported findings from national online surveys in 2006 and 2011 and completed a third survey in 2016.

In addition to the 10 ideas for alarm management, this compendium presents a set of default alarm parameters reported in a survey conducted by the AAMI Foundation, which represents responses from 17 of the 25 hospitals and healthcare systems in the National Coalition for Alarm Management Safety. These parameters could be used to benchmark settings on alarm systems for specific adult and pediatric patient populations.

Alarm fatigue is an important technological hazard that adversely affects patient safety and the healthcare team. Nurses can be exposed to an excessive amount of alarms during their work which may lead to alarm fatigue. OBJECTIVE: To determine the experiences of alarm fatigue among nurses working in intensive care units and other inpatient clinics.

Alarm fatigue among nurses working in the intensive care unit has garnered considerable attention as a national patient safety priority. A viable solution for reducing the frequency of alarms and unnecessary noise is intensive care unit alarm monitor customization.

When exposed to hundreds of medical device alarms per day, intensive care unit (ICU) staff can develop “alarm fatigue” (i.e., desensitisation to alarms). However, no standardised way of quantifying alarm fatigue exists. We aimed to develop a brief questionnaire for measuring alarm fatigue in nurses and physicians. After developing a list of initial items based on a literature review, we conducted 15 cognitive interviews with the target group (13 nurses and two physicians) to ensure that the items are face valid and comprehensible. We then asked 32 experts on alarm fatigue to judge whether the items are suited for measuring alarm fatigue. The resulting 27 items were sent to nurses and physicians from 15 ICUs of a large German hospital. We used exploratory factor analysis to further reduce the number of items and to identify scales. A total of 585 submissions from 707 participants could be analysed (of which 14% were physicians and 64% were nurses). The simple structure of a two‑factor model was achieved within three rounds. The final questionnaire (called Charité Alarm Fatigue Questionnaire; CAFQa) consists of nine items along two scales (i.e., the “alarm stress scale” and the “alarm coping scale”). The CAFQa is a brief questionnaire that allows clinical alarm researchers to quantify the alarm fatigue of nurses and physicians. It should not take more than five minutes to administer.

This study aimed to determine the degree of alarm fatigue and mental workload of ICUnurses, and to clarify the relationship between these two variables. A cross-sectional, descriptiveresearch design was used. Data were collected from 90 nurses working in four ICUs in Seoul, Republicof Korea, using a questionnaire determining their degree of alarm fatigue and mental workload.Data were collected from 6 March to 26 April 2021 and were analyzed using at-test, ANOVA, andPearson’s correlation coefficient. The average alarm-fatigue score was 28.59 out of 44. The item withthe highest score was “I often hear a certain amount of noise in the ward”, with a score of 3.59 out of4. The average of the mental workload scores was 75.21 out of 100. The highest mental workloaditem was effort, which scored 78.72 out of 100. No significant correlation was found between alarmfatigue and mental workload. Although nurses were consistently exposed to alarm fatigue, this wasnot directly related to their mental workloads, perhaps owing to their professional consciousnessas they strived to accomplish tasks despite alarm fatigue. However, since alarm fatigue can affectefficiency, investigations to reduce it and develop appropriate guidelines are necessary. This studywas not registered.