The effect of educational interventions in managing nurses' alarm fatigue: An integrative review

Abstract

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.

Determining Factors of Alarm Fatigue among Nurses in Intensive Care Units—A Polish Pilot Study

“…Asadi et al confirm this by reporting that the fatigue in nurses who were trained in working with ventilators and alarm settings was significantly lower [26]. According to the authors of the 2022 review, education may be key to minimising fatigue [10]. A 2019 project conducted in China revealed similar findings.…”

“…Fatigue caused by alarms is increasingly recognized as a serious problem related to patient safety in contemporary clinical practice [10]. The specificity of work in ICUs led critical care nurses to report low positive patient safety attitudes [11].…”

Levels and Factors of Nurses’ Alarm Fatigue in Critical Care Settings in Saudi Arabia: A Multicenter Cross-Sectional Study

“…There are factors that may contribute to enhancing alarm fatigue among nurses and need to be investigated to provide future strategic plan to manage them. In a recent study that was conducted by Nyarko et al 2023, 13 factors such as years of experience in the critical care unit and having policies related to alarm management, type of intensive care units were associated with an increased risk of alarm fatigue. Another study has shown that appeared that nurses’ alarm fatigue was negatively correlated with their participation in ward monitoring device training programs and positively correlated with working 12-hour shifts (as opposed to 8-hour and 24-hour shifts) and working in Intensive Cardiac Surveillance Units (as opposed to other ICUs).…”

“… 6 False alarms may result in undesired actions such as ignoring or reducing the frequency of alarms, deactivating or silencing vital alarms, establishing inappropriate alarm parameters and turning down the level of alarms, all of which may affect patients’ health outcomes and threaten their lives. 10 , 13–15 Between January 2009 and June 2012, the Joint Commission on Accreditation of Healthcare Organizations received 98 alarm-related incidents; 80 of these incidents resulted in fatalities, 13 in constant function loss, and five in unexpectedly extended hospitalizations. 16 Consequently, the Joint Commission established the National Patient Safety Goals in 2014 to control and adjust the alarm safety standards.…”

The effect of intelligent management interventions in intensive care units to reduce false alarms: An integrative review

“…However, excessive amounts of clinical alarms may be the result of multiple factors. Alarm management solely through evidence-based interventions or training healthcare professionals to change their perceptions does not adequately address the high number of false alarms, alarm fatigue among healthcare professionals, and the low positive predictive value of alarm systems [ 20 ]. The risks resulting from alarms generated by various devices that are not handled promptly would be mitigated if some technical measures can be adopted, such as intelligent devices to reduce the number of false alarms, identify critical alarms, and notify healthcare professionals to respond in a timely manner.…”