Alarm Management in Intensive Care: Qualitative Triangulation Study

Area of Science:

• Clinical Informatics
• Human-Computer Interaction
• Healthcare Management

Background:

• High rates of unnecessary alarms in intensive care units (ICUs) contribute to alarm fatigue.
• Alarm fatigue compromises patient safety and necessitates effective alarm management strategies.

Purpose of the Study:

• To investigate nurse and physician interactions with patient monitoring systems.
• To understand perceptions of current alarm management practices.
• To explore views on smart alarm management solutions.

Main Methods:

• Qualitative, ethnographic, multimethods study in a German university hospital ICU.
• Data collection included 102 hours of field observations and 12 semistructured interviews.
• Inductive, grounded theory approach used for data analysis.

Main Results:

• Staff interact with continuous vital sign monitoring systems throughout their work.
• No standardized alarm management protocols exist; reactions are ad hoc and perceived as problematic.
• Intelligent alarm management is viewed positively if suggestions are understandable and traceable.

Conclusions:

• Patient monitoring system interactions are integral to ICU workflows and decision-making.
• Existing alarm management standards and workflows are deficient.
• Future alarm management solutions must prioritize user needs, workflows, and real-world data.