Intensive care unit nurses' perceptions and practices regarding clinical alarms: A descriptive study.
Lei Wang, Wei He, Yulu Chen and 4 others
PMID 37101342WHAT IT FOUND
Most ICU nurses believe they respond quickly to alarms, but nearly half admit missing them due to noise and complexity.
While 81% claim sensitivity, 25% report alarms are often unheard. This gap between perceived and actual response suggests alarm fatigue is masking safety risks.
Key findings
0181.28% of nurses believed they were sensitive to alarms and responded quickly, yet 24.94% admitted alarms were often not heard and missed.
0262.47% of nurses agreed nuisance alarms disturbed their care of patients, and 49.03% said these alarms reduced their trust, leading them to turn off alarms instead of setting them correctly.
03During a 14-day observation of 32 patients, 13,829 physiological monitor alarms were recorded, averaging about 988 alarms per day, with no alarm-related adverse events observed in that specific period.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The observational study was conducted in a single ICU over only 14 days, which may not represent typical alarm frequencies or patient acuity across different times or units. The survey relied on self-reported perceptions of alarm response, which may overestimate actual performance due to social desirability bias or the Hawthorne effect. The study was limited to one region in China, so findings may not generalize to other healthcare systems with different staffing ratios or alarm technologies. No objective data on actual nurse response times to alarms were collected, only the nurses' own beliefs about their sensitivity.
Declared interests
The authors declared no conflict of interest, and the study received no external funding.
The easy way to misread this
Do not assume that high self-reported sensitivity to alarms means patient safety is secure. The study shows that despite 81% of nurses believing they respond quickly, nearly 25% admit to missing alarms, and half report turning them off due to nuisance fatigue. Self-perception of vigilance does not guarantee effective alarm management.