Background: Nurses working in an intensive care unit (ICU) are dependent on various medical devices to assist with patient monitoring, care and safety. Alarm fatigue is a consequence of an excessive number of alarms in the practice environment. The goal of this research was to identify the effect of applying alarm fatigue strategies related to nursing performance and to evaluate nurses’ perceptions concerning to alarm fatigue in intensive care unit King Abdullah medical city, Makkah. Methods: The study type was a cross-sectional design. A sample of 85 nurses was obtained using a survey instrument that was created using a structured self-administered questionnaire designed based on literature review. Results: The most rated mean score for Strategies that reduce the alarm fatigue was education and remaining was optimized technology, electrodes, setup customized alarms, and attitude respectively. When proving hypothesis, the findings demonstrate that there are no statistically significant differences between the nurses’ alarm fatigue with study variables including gender, age, professional experience and staff position. The use of an evidence-based alarm management strategy can reduce alarm fatigue and ensure the safety of all monitored patients. Therefore, the above strategies on alarm management will be beneficial to reduce the alarm fatigue. Conclusions: This study’s findings have several practical implications on reducing alarm fatigue in intensive care unit. Nurses play a significant role on monitoring the patients, which may leads to alarm related fatigue.

Context: Language and cultural barriers between patients and nurses can contribute to patient safety, dissatisfaction, and poor quality of care, especially with Hajj patients. Effective communication between patients and nurses is key to safe and quality nursing care. Multicultural and multi-language barriers stand in the way of this effective communication, so an in-depth study is needed to describe this phenomenon based on nurses' perspectives. Aim: This research aims to identify issues and challenges related to the cultural and language differences between patients and nurses during the Hajj season and to describe nurses' experiences in providing care in a multicultural and multi-language healthcare setting during the Hajj season. Methods: Qualitative descriptive design. Five Hospitals in Makkah Health clusters were selected for this study. A purposive sample of 50 nurses was recruited for this study. The data collection Procedure includes Audio-recorded interviews using semi-structured questionnaires. Results: Most participants identified language differences in their caring experience for Hajj patients. Because the participants felt unable to communicate with patients effectively, the language barrier affected nursing care. Despite the challenges of taking care of patients with different cultures, the majority of the staff feel it is a good experience for them. The last major theme identified in the study was the understanding of trans-cultural nursing. Most participants were honest enough to tell that they do not know at all that transcultural nursing means. Some participants were familiar with the term but were unsure what it meant or how to explain it, and a few knew the term and its concept. Conclusion: Nurses had difficulty communicating with patients due to the language barrier. Providing an interpreter or translator, seeking assistance from the patient's relations officer, and using technology such as Google Translate to address this issue are all possible solutions. The study recommends addressing the cultural barriers; all the nurses should attend the education and training on trans-cultural nursing in advance for the staff chosen to work during Hajj.