Management of medical device alarms in intensive care units: A scoping review

The presence of medical device alarms in the intensive care unit (ICU) has increased significantly over the past decade due to technological advancements. A troubling paradox is that while alarms are designed to keep patients safe, the overabundance of noise and frequency of nonactionable alarms is associated with alarm fatigue in nurses.

The objectives of this study were to explore and describe the interventions and recommendations for alarm management of medical devices in the ICU environment.

This scoping review was conducted using the Joanna Briggs Institute framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

Data sources included APA PsycINFO (Ovid), EBSCO CINAHL, Elsevier Embase, Emcare (Ovid), Epistemonikos, MEDLINE (Ovid), PROSPERO, Elsevier Scopus (Ovid), and Clarivate Analytics Web of Science Core Collection from 1st January 2014 to 31st December 2024 and supplemented with hand searching of references from included studies.

A total of 44 studies met the inclusion criteria: 28 were quantitative, 12 were qualitative, and four were mixed-method studies. The most common intervention utilised for the management of medical device alarms was clinical education followed by alarm customisation. A total of 150 recommendations to manage medical device alarms were made that were themed into a collaborative framework to guide improvements.

There is no single or easy intervention that will address the management of clinical alarms in the ICU. There is a strong need for shared responsibility across the critical care faculty that requires effective collaboration, ongoing involvement, and vigilance across whole multidisciplinary ICU team.