Nurse Competence on Physiologic Monitors Use: Toward Eliminating Alarm Fatigue in Intensive Care Units

Area of Science:

• Nursing Informatics
• Patient Safety
• Clinical Engineering

Background:

• Limited research exists on nurse competence in alarm management, focusing on narrow skill sets.
• This study addresses the need for assessing nurse competence in using physiologic monitors, crucial for the National Patient Safety Goal on clinical alarm systems safety.

Purpose of the Study:

• To assess nurses' perceived competence in using physiologic monitors within intensive care units (ICUs).
• To develop and validate a reliable tool for measuring nurse competence on physiologic monitor use.
• To identify specific training needs for improving safe and effective use of these devices.

Main Methods:

• A descriptive study was conducted in a Magnet hospital's ICUs.
• A Nurse Competence on Philips Physiologic Monitors Use Survey was developed and validated by 13 expert ICU nurses.
• The survey comprised 59 items across 5 subscales, including advanced functions, and two open-ended questions; 30 ICU nurses participated.

Main Results:

• The survey demonstrated high reliability and construct validity.
• 3-27% of nurses lacked confidence in specific monitor functions, and 3-40% were unfamiliar with 27 features.
• Nurses requested training on alarm troubleshooting, central-station navigation, and the use of unit-specific super users.

Conclusions:

• This is the first study to create and test a comprehensive list of competencies for physiologic monitor use.
• Rigorous, individualized, and periodic training is essential to enhance safe monitor use, reduce alarm fatigue, and manage technical alarms effectively.
• Developing super users and conducting usability testing for complex medical devices are recommended strategies for improving navigation and safety.