Abstract
Background: Customizing monitor alarm settings to individual patients can reduce alarm fatigue in intensive care units (ICUs), but has not been widely studied. Objectives: To understand ICU nurses' approaches to customization of electrocardiographic (ECG) monitor alarms. Methods: A convergent mixed methods study was conducted in 3 ICUs in 1 hospital. Data on the type and frequency of ECG alarm customization were collected from patient monitors (n=298). Nurses' customization clinical reasoning was explored through semi-structured interviews (n=27). Results: Of the 298 patients, 58.7% had ≥1 alarm(s) customized. Heart rate limits, irregular heart rate, and atrial fibrillation were the most commonly customized alarms. Interviews revealed that customization practices varied widely and were influenced by factors including clinical expertise, lack of customization education, and negative experiences. Conclusion: Alarm customization is nuanced and requires adequate support to develop safe and effective practices. The challenges identified can inform development of strategies to improve alarm customization.
| Original language | English (US) |
|---|---|
| Journal | Heart and Lung |
| DOIs | |
| State | Accepted/In press - Jan 1 2018 |
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Keywords
- Alarm Customization
- Clinical Alarms
- Critical Care Nursing
- Electrocardiography
- Intensive Care Units
- Physiologic Monitor Alarms
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine
Cite this
Challenges of customizing electrocardiography alarms in intensive care units : A mixed methods study. / Ruppel, Halley; Funk, Marjorie; Kennedy, Holly Powell; Bonafide, Christopher P.; Wung, Shu-Fen; Whittemore, Robin.
In: Heart and Lung, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Challenges of customizing electrocardiography alarms in intensive care units
T2 - A mixed methods study
AU - Ruppel, Halley
AU - Funk, Marjorie
AU - Kennedy, Holly Powell
AU - Bonafide, Christopher P.
AU - Wung, Shu-Fen
AU - Whittemore, Robin
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: Customizing monitor alarm settings to individual patients can reduce alarm fatigue in intensive care units (ICUs), but has not been widely studied. Objectives: To understand ICU nurses' approaches to customization of electrocardiographic (ECG) monitor alarms. Methods: A convergent mixed methods study was conducted in 3 ICUs in 1 hospital. Data on the type and frequency of ECG alarm customization were collected from patient monitors (n=298). Nurses' customization clinical reasoning was explored through semi-structured interviews (n=27). Results: Of the 298 patients, 58.7% had ≥1 alarm(s) customized. Heart rate limits, irregular heart rate, and atrial fibrillation were the most commonly customized alarms. Interviews revealed that customization practices varied widely and were influenced by factors including clinical expertise, lack of customization education, and negative experiences. Conclusion: Alarm customization is nuanced and requires adequate support to develop safe and effective practices. The challenges identified can inform development of strategies to improve alarm customization.
AB - Background: Customizing monitor alarm settings to individual patients can reduce alarm fatigue in intensive care units (ICUs), but has not been widely studied. Objectives: To understand ICU nurses' approaches to customization of electrocardiographic (ECG) monitor alarms. Methods: A convergent mixed methods study was conducted in 3 ICUs in 1 hospital. Data on the type and frequency of ECG alarm customization were collected from patient monitors (n=298). Nurses' customization clinical reasoning was explored through semi-structured interviews (n=27). Results: Of the 298 patients, 58.7% had ≥1 alarm(s) customized. Heart rate limits, irregular heart rate, and atrial fibrillation were the most commonly customized alarms. Interviews revealed that customization practices varied widely and were influenced by factors including clinical expertise, lack of customization education, and negative experiences. Conclusion: Alarm customization is nuanced and requires adequate support to develop safe and effective practices. The challenges identified can inform development of strategies to improve alarm customization.
KW - Alarm Customization
KW - Clinical Alarms
KW - Critical Care Nursing
KW - Electrocardiography
KW - Intensive Care Units
KW - Physiologic Monitor Alarms
UR - http://www.scopus.com/inward/record.url?scp=85051652393&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85051652393&partnerID=8YFLogxK
U2 - 10.1016/j.hrtlng.2018.06.010
DO - 10.1016/j.hrtlng.2018.06.010
M3 - Article
C2 - 30122549
AN - SCOPUS:85051652393
JO - Heart and Lung: Journal of Acute and Critical Care
JF - Heart and Lung: Journal of Acute and Critical Care
SN - 0147-9563
ER -