Crying wolf, alarm safety and management in paediatrics: A scoping review.
Roni Cole, Geraldine Roderick, Osayed Cheema and 2 others
PMID 39323016WHAT IT FOUND
Alarm definitions and measurement methods vary widely across 37 paediatric and neonatal studies, preventing comparison of interventions.
Most research focuses on critical care in the US. Changing alarm parameters is the most common strategy, but inconsistent terminology makes it impossible to determine which approaches truly improve patient safety.
Key findings
01Only 46% of included studies provided a definition for what constitutes an alarm, and terminology varied significantly between studies.
02The majority of interventions focused on changing alarm parameters rather than broader system reforms, and only 19% of studies measured clinician response to alarms.
03Evidence is heavily skewed toward US-based critical care settings, with little research on non-physiological alarms like infusion pumps or nurse call systems.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review only included English-language publications from the last 10 years. Most studies were from the US and focused on critical care, limiting generalizability to other settings and countries. The heterogeneity of alarm definitions and outcomes prevented meta-analysis or direct comparison of intervention effectiveness. Many included studies were quality improvement projects, which may not be generalizable.
Declared interests
The authors declared no conflicts of interest. The study was supported by a SERTF-Wishlist Clinician Researcher Fellowship Scheme.
The easy way to misread this
Do not assume that changing alarm parameters has been proven to improve patient safety. The review found that while this is the most common intervention, the lack of standardized definitions and outcome measures means there is no clear evidence that these changes reduce adverse events or improve clinician response times.