Alarms in a neurocritical care unit: a prospective study

Area of Science:

• Critical Care Medicine
• Biomedical Engineering
• Nursing Informatics

Background:

• Current critical care monitoring relies on high-sensitivity, low-specificity alarm systems.
• This leads to excessive alarms, potentially causing alarm fatigue and reduced care quality.

Purpose of the Study:

• To determine the prevalence, types, and causes of alarms in a neurological critical care unit (NCCU).

Main Methods:

• A one-month observational study in a university NCCU.
• Nursing staff recorded alarm types and counts for 34 patients (272 monitoring days).
• Alarms were categorized as type-A (nurse-handled), type-B (nurse/physician), and type-C (physician-handled).

Main Results:

• A total of 9,439 alarms were recorded, averaging 34.7 alarms per bed daily.
• Most alarms were type-A (57.7%), followed by type-B (39.2%) and type-C (3.1%).
• Electrocardiogram and pulse oximeter were the primary sources (34.6% and 33.7%, respectively).
• Diurnal variations were noted for specific alarm types and monitoring devices.

Conclusions:

• Alarms are highly prevalent in NCCUs, constituting a significant workload component.
• Understanding alarm characteristics is crucial for optimizing monitoring and reducing alarm fatigue.