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
N1 - Funding Information:
Funding: This work was supported by the Sigma Theta Tau International Doris Bloch award and the Connecticut Nurses’ Foundation research grant. Halley Ruppel is a Robert Wood Johnson Foundation Future of Nursing Scholar.
Funding Information:
Declarations of interest: Halley Ruppel and Marjorie Funk have received research funding from Philips Healthcare.
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/9/1
Y1 - 2018/9/1
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
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U2 - 10.1016/j.hrtlng.2018.06.010
DO - 10.1016/j.hrtlng.2018.06.010
M3 - Article
C2 - 30122549
AN - SCOPUS:85051652393
VL - 47
SP - 502
EP - 508
JO - Heart and Lung: Journal of Acute and Critical Care
JF - Heart and Lung: Journal of Acute and Critical Care
SN - 0147-9563
IS - 5
ER -