Call for Decision Support for Electrocardiographic Alarm Administration Among Neonatal Intensive Care Unit Staff:...

Area of Science:

• Neonatal Intensive Care Unit (NICU) Medicine
• Clinical Engineering
• Healthcare Informatics

Background:

• Electrocardiographic (ECG) alarms in NICUs often have high sensitivity and low specificity, contributing to alarm fatigue and potential negative impacts on neonatal development.
• Underreporting of adverse events and staff fatigue are significant concerns associated with current ECG alarm systems.

Purpose of the Study:

• To conduct a nationwide, multicenter, large-sample cross-sectional survey to assess current practices and decision-making needs of healthcare providers regarding ECG alarms.
• To identify the perceptions and decision-support requirements of NICU staff concerning clinical ECG alarms.

Main Methods:

• A nationwide cross-sectional survey was administered to NICU staff in 27 Chinese provinces.
• Data were collected on clinical practices, perceptions, decision-making processes, and decision-support needs related to ECG alarms.
• Comparative analyses were performed using chi-square, Kruskal-Wallis, and Mann-Whitney U tests.

Main Results:

• 1019 NICU staff participated, reporting numerous nuisance alarms and negative perceptions of ECG alarm systems.
• Physicians, and staff with higher education and job titles, exhibited more negative perceptions.
• A significant majority (62.32%) found difficulty in modifying alarm parameters, with intelligent module-assisted decision support systems being the most desired.

Conclusions:

• NICU staff demonstrate negative perceptions and significant decision-making requirements for handling ECG alarms.
• Healthcare policymakers must prioritize these decision-making needs and implement diverse decision-support solutions to mitigate alarm fatigue and improve patient care.