Exploring intensive care unit nurses' decision-making in alarm management: A qualitative study.

Area of Science:

• Nursing Science
• Patient Safety
• Healthcare Management

Background:

• Alarm fatigue, caused by frequent nonactionable alarms, leads to nurse desensitization and risks patient safety.
• It is a growing concern in critical care settings requiring further investigation.
• Understanding alarm management is crucial for mitigating risks.

Purpose of the Study:

• To explore Intensive Care Unit (ICU) nurses' decision-making processes regarding alarm recognition, triage, and response.
• To gain insights into how nurses manage alarms in a complex ICU environment.

Main Methods:

• Qualitative study involving in-depth, semi-structured interviews with 12 ICU nurses.
• Interpretive Description methodology was employed to analyze decision-making.
• Thematic analysis identified key themes in alarm response.

Main Results:

• Nurses' decision-making involved three stages: awareness, triage, and response prioritization.
• Factors influencing awareness included competing tasks, unit busyness, staffing, noise, and false alarms.
• Triage and response were influenced by experience, alarm characteristics, fatigue, burnout, patient acuity, and medication infusions.

Conclusions:

• Implementing a positive safety culture, standardized alarm education, and mentorship is recommended.
• These interventions aim to optimize alarm response and management.
• Reducing alarm fatigue is essential for enhancing patient safety.