Background: Alarm fatigue is becoming more widely acknowledged as a serious safety concern in modern clinical practice. Nurses are not always proficient in the alarms' functions and capabilities, and they do not undertake training regularly. Educating nurses on alarms maintains their knowledge and abilities in complex clinical settings. Some education has been undertaken to improve clinical alarm response, but the evidence for evaluating the effectiveness of nurse education interventions is limited. Objective: To evaluate the effects of educational interventions for reducing alarm fatigue in nurses, including the reduction of excessive, false and non-actionable alarms, which are major factors causing alarm fatigue in nurses. Data sources: PUBMED, EMBASE, CINAHL, SCOPUS and OVID databases were systematically searched from 2016 to 2021. Design: Integrative Review.Review methods: An integrative review of literature was performed using the PRISMA checklist. Critical appraisal was done using Joanna Briggs Institute level of evidence.Results: Thirteen studies met the inclusion criteria. The results of most studies showed that educational intervention was beneficial for reducing the total number of alarms and false alarms. Furthermore, nurses' perceptions and knowledge improved, but the reduction in nurses' alarm fatigue is uncertain. A positive effect in alarm management practices was identified after the educational intervention. Conclusion:Educational intervention may be the way to manage nurses' alarm fatigue. The use of medical devices in hospitals is increasing exponentially, and for this reason, alarms are inevitable. The introduction of effective and continuous education and training programs for nurses concerning clinical alarm management as well as raising nurses' awareness of the occurrence of alarm fatigue is vital.

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Objective To explore the nurses’ behaviors regarding clinical alarms, analyze the related influencing factors, and provide rationales for alarm management. Methods A cross-sectional survey was conducted in China. The self-made questionnaire of nurses’ clinical alarm-related knowledge, attitude, and behavior (NCAKAB) was used. Results The valid response rate was 98.66% (n = 2368). The average nurses’ clinical alarm-related behaviors (NCAB) score was 65.14 ± 7.95 (out of 85). The dimension scores of NCAB from high to low were alarm learning (4.02 ± 0.85, out of 5), alarm response (27.99 ± 3.64, out of 35), alarm setting (19.24 ± 3.88, out of 25), alarm recognition (7.63 ± 1.68, out of 10) and alarm notification (6.25 ± 1.84, out of 10). There were significant differences in alarm behavior scores between nurses of different ages (F = 4.619, P = 0.000), nursing stints (F = 9.564, P = 0.000), professional titles (F = 4.425, P = 0.004), departments (F = 9.166, P = 0.000), and hospital levels (t = 2.705, P = 0.007). The study showed that nurses’ total alarm behavior scores were positively correlated with the total alarm knowledge score (r = 0.267; P < 0.001) and the total alarm attitude score (r = 438; P < 0.001). Conclusions Nurses scored highest in alarm learning, followed by alarm response, alarm setting, alarm recognition, and alarm notification behavior. The factors that influenced alarm behavior included age, title, department, nursing stint, hospital level, professional title, alarm-related training, willingness to participate in alarm-related training, whether or not departments have improved alarm management over the last 3 years, and whether or not departments have formulated norms for alarm management. Nurses with higher scores for clinical alarm knowledge had higher correlating scores for alarm behavior; similarly, nurses with higher scores for clinical alarm attitude had higher scores for alarm-related behavior.