Alarm Fatigue, Perceived Stress, and Job Burnout Among ICU Nurses: A Cross-Sectional Study

Alarm fatigue in intensive care units is associated with increased nurse stress and burnout; however, the mechanism underlying these associations remains underexplored. This study aimed to assess alarm fatigue, perceived stress, and job burnout levels among intensive care unit nurses; identify factors associated with burnout; and test the statistical mediating role of perceived stress in the association between alarm fatigue and burnout.

A cross-sectional study was conducted in October 2024, with nurses recruited via convenience sampling from ICUs at hospitals affiliated with Shahid Beheshti University of Medical Sciences in Tehran, Iran. Data were collected using the Alarm Fatigue Questionnaire, the Perceived Stress Scale, and the Persian Copenhagen Burnout Inventory. Multiple linear regression and path analysis were used for data analysis. The study adhered to established reporting guidelines for observational studies.

A total of 110 intensive care unit nurses participated. Participants reported high alarm fatigue (mean = 36.57, SD = 3.50), high perceived stress (mean = 38.35, SD = 7.02), and moderate job burnout (mean = 54.18, SD = 15.12). Regression analysis showed that shift type (β = -0.341, p = 0.020), perceived stress (β = 0.209, p = 0.038), and alarm fatigue (β = 0.235, p = 0.013) were significant predictors of burnout, explaining 36.5% of the variance. Path analysis demonstrated that perceived stress statistically mediated the association between alarm fatigue and burnout (β = 0.10, p = 0.015).

In this cross-sectional sample, perceived stress statistically mediated the association between alarm fatigue and burnout in intensive care unit nurses. These findings suggest that interventions targeting stress reduction may potentially attenuate alarm fatigue-related burnout, though longitudinal studies are needed to confirm directionality. Nursing administrators should prioritize integrated strategies for managing alarms and stress to improve nurse well-being.