Original Research: Alarm Fatigue: Exploring the Adaptive and Maladaptive Coping Strategies of Nurses
Olawunmi Obisesan1, Ericka Barber, Patricia Martin
1Olawunmi Obisesan is the research and outcomes manager at Missouri Baptist Medical Center, St. Louis. Ericka Barber and Patricia Martin are clinical education specialists for medical oncology service lines, Nicole Brougham is a senior practice project coordinator, and Heidi Tymkew is a research scientist, all at Barnes-Jewish Hospital, St. Louis. Contact author: Olawunmi Obisesan, olawunmi.obisesan@bjc.org . The authors have disclosed no potential conflicts of interest, financial or otherwise.
Background:
To improve patient safety, hospitals use alarm notification systems to increase nurses' real-time situational awareness of a patient's condition. Such alarms are critical to nurses' clinical decision-making and prioritization, thus helping to improve patient care and care efficiency. But the frequent and often simultaneous ringing of alarms, including many that are false, nonemergent, or nonactionable, has led to overwhelm, alarm distrust, and desensitization, resulting in alarm fatigue.
Purpose:
This study aimed to explore oncology nurses' lived experiences with alarms and the adaptive and maladaptive strategies they use to cope with alarm fatigue.
Methods:
This qualitative, phenomenological study was guided by the theoretical framework of the Roy Adaptation Model. A purposive sample of nine nurses was recruited from two oncology units at a large midwestern Magnet hospital in the United States. Qualitative data were collected using a six-question, semistructured interview guide. Interviews were conducted either face-to-face in a private conference room on the unit or via the online videoconferencing platform Zoom.
Results:
Data analysis yielded five themes, the most prominent being the high volume and frequency of alarms . Nurse participants reported adopting more maladaptive than adaptive coping strategies. Overall, they felt that the high frequency of false, nonemergent, and nonactionable alarms disrupted their workflow and contributed to a general desensitization to alarms.
Conclusions:
This study's findings offer valuable insight into the problem of alarm fatigue among nurses. Practical measures are urgently needed to reduce nurses' cognitive overload; shift nonnursing responsibilities to other staff; and implement efficiency-focused process changes, such as reengineering workflows to minimize interruptions. Every effort should be made to redesign protocols to reduce alarm fatigue, including by decreasing the number of false, nonemergent, and nonactionable calls and alarms.
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