Alarm fatigue can adversely affect nurses' efficiency and concentration on their tasks, which is a threat to patients' safety. The purpose of the present study was to develop and test the psychometric accuracy of an alarm fatigue questionnaire for nurses. This study was conducted in two stages: in stage one, in order to establish the different aspects of the concept of alarm fatigue, the researchers reviewed the available literature-articles and books-on alarm fatigue, and then consulted several experts in a meeting to define alarm fatigue and develop statements for the questionnaire. In stage two, after the final draft had been approved, the validity of the instrument was measured using the two methods of face validity (the quantitative and qualitative approaches) and content validity (the qualitative and quantitative approaches). Test-retest, Cronbach's alpha, and Principal Component Analysis were used for item reduction and reliability analysis. Based on the results of stage one, the researchers extracted 30 statements based on a 5-point Likert scale. In stage two, after the face and content validity of the questionnaire had been established, 19 statements were left in the instrument. Based on factor loadings of the items and "alpha if item deleted" and after the second round of consultation with the expert panel, six items were removed from the scale. The test of the reliability of nurses' alarm fatigue questionnaire based on the internal homogeneity and retest methods yielded the following results: test-retest correlation coefficient = 0.99; Guttman split-half correlation coefficient = 0.79; Cronbach's alpha = 0.91. Regarding the importance of recognizing alarm fatigue in nurses, there is need for an instrument to measure the phenomenon. The results of the study show that the developed questionnaire is valid and reliable enough for measuring alarm fatigue in nurses.

Objective. To evaluate the effects of application of a manual on the improvement of alarms management in Intensive Care Units (ICU). Methods. This quasi-experimental study evaluated the effectiveness of the introduction into of a manual for alarm management and control in the ICU of a hospital in southeastern Iran. The intervention was a 4-hour workshop was on topics related to the adverse effects of alarms, standardization of ECG, oxygen saturation and blood pressure monitoring systems, and the use of ventilators and infusion pumps. Data were collected thorough 200 hours of observation of 60 ICU nurses (100 hours’ pre-intervention and 100 hours’ post-intervention). Response time, type of response, customization of alarm settings for each patient, the person responding to an alarm, and the cause of the alarm were analyzed. Alarms were classified into three types: false, true and technical. Results. The results showed a statistically significant difference between the pre- and post-intervention frequency of alarm types, frequency of monitoring parameters, customized monitoring settings for patients, and individuals who responded to alarms. The percentage of effective interventions was significantly higher for all parameters after the intervention (46.9%) than before the intervention (38.9%). Conclusion. The employment of a manual for management of alarms from electronic equipment in ICUs can increase the frequency of appropriate responses to alarms in these units.