Improved pointer in auditory alarms enhances response accuracy

Auditory alarms are crucial in clinical settings, alerting clinicians to events requiring immediate attention. However, multitasking can lead to missed alarms and disrupt patient care. Enhancing auditory alarms can improve patient safety and clinician satisfaction.

In a controlled laboratory study, we recruited 26 clinicians (residents, fellows, advanced practice providers) and 19 non-clinicians (undergraduate students) to compare our previously validated alarm with an improved design. The improved alarm incorporates a 'pointer' (a short sound burst indicating acuity levels) enriched with harmony, intervallic change, roughness, and glissando to provide additional information to users. We measured response accuracy (correct alarm identification) and response time (seconds to respond).

A total of 26 clinicians and 19 non-clinicians were recruited and all participants met inclusion criteria for analysis. A mixed analysis of variance revealed a large main effect of the pointer on response accuracy (F(1,44)=9.11, P=0.004, η² =0.17). Accuracy was higher for our improved pointer (M=0.90, 95% confidence interval [CI; 0.84-0.95]) than for our previous design (M=0.80, 95% CI [0.74-0.87]). Ascending alarms representing hypertension yielded a mean response accuracy of 0.89 (95% CI 0.84-0.94) and descending alarms representing hypotension yielded a mean response accuracy of 0.81 (95% CI 0.75-0.88). Low acuity ascending alarms resulted in slower response times compared with other combinations, where acuity of change was conveyed through intervallic difference of two-note harmonies.

Improved pointers demonstrated statistically significant accuracy improvement for clinicians and non-clinicians without compromising response time-a design advantage that can influence the revision of the international alarm standard and improve patient safety.