CAPSTONE PROJECT SOURCES

Alarm Fatigue and How to Reduce It

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Capstone Project Sources

1. Impact of alarm fatigue on the work of nurses

a. Reference: Lewandowska, K., Weisbrot, M., Cieloszyk, A., Medrzycka-Dabrowska, W., Krupa, S., & Ozga, D. (2020). Impact of alarm fatigue on the work of nurses in an intensive care environment: A systematic review. International Journal of Environmental Research and Public Health, 17(22), 8409. Doi: 10.3390/ijerph17228409

b. Date of Publication: 2020

c. Authors: Katarzyna Lewandowska, Magdalena Weisbrot, Aleksandra Cieloczyk, Wioletta Medrzycka, Sabina Krupa and Dorota Ozga

d. Bias: There was no apparent bias in the study

e. Precisely Completed: The study appears to have been precisely completed, although precision could be enhanced by increasing the number of reviewed studies. Relevant studies were sourced from recognized databases such as Cochrane Library, ProQuest Nursery, EBSCO, OVID, and PubMed. 7 studies were included in the final review and data analyzed both quantitatively and descriptively, with a total of 389 nurses tested. The studys precision was increased by the fact that five of the studies measured the quantitative impact of alarms based on the Healthcare Technology Foundation questionnaire, while only two studies derived from a qualitative model.

f. Applicability: This study is applicable to the capstone project. It provides a justification on the negative effects of alarm fatigue on patients. The study findings enhance the capstone projects feasibility.

g. Outcomes: Results of this document suggest that alarm fatigue results in serious consequences for both patients and nursing personnel. The inconvenience caused by alarms results in disturbances in patient care, and a reduction of trust in the alarm management system among nursing personnel as they are not able to respond effectively.

h. Comments and Grading: It would be appropriate for the study to explain how alarm fatigue affects specific aspects of patient care. This being a systematic review qualifies as level A of evidence under the AACN (American Association of Critical Care Nurses) levels of evidence. This could be graded as high quality of evidence.

2. Effects of monitor alarm management training on nurses alarm fatigue

a. Reference: Bi, J., Yin, X., Li, H., Gao, R., Zhang, Q., Zhong, T., Zan, T., Guan, B., & Li, Z. (2020). Effects of monitor alarm management training on nurses alarm fatigue: A randomized controlled trial. Journal of Clinical Nursing, 29(21), 4203-4216.

b. Date of Publication: 2020

c. Authors: Bi, Jiasi, Xin Yin, Hongyan Li, Ruitong Gao, Qing Zhang, Tangsheng Zhong, Tao Zan, Baoxing Guan, and Zhen Li

d. Bias: There was no apparent bias in the study

e. Precisely Completed: the study appears to have been precisely completed for two reasons. First, the sample size of 93 (47 in experimental group and 46 in control group) is adequate for the study population as it exceeds the estimated sample size of 68 calculated using G*power. This ensures that the sample size remained within the estimated range even if some participants dropped out (loss from follow-up). Secondly, the groups are comparable as all participants are ICU nurses in the same facility, who are only separated by exposure status.

f. Applicability: This study is very applicable to the capstone project. The project seeks to determine ways of reducing alarm fatigue among nurses and how to reduce it. The findings of this study provide crucial insights on the effectiveness of alarm management training as a strategy for reducing alarm fatigue among nurses. Further, the methodology adopted offers the capstone project a means to assess the success of such a training in a healthcare organization.

g. Outcomes: Results of this document suggest that alarm management training helps lower alarm fatigue among ICU nurses as shown by the fact that nurses in the experimental group reported lower post-intervention fatigue scores...…studies. Thus, it could be categorized under level C of evidence, which is graded as moderate quality evidence.

5. The impact of the CEASE bundle of the AACN in decreasing alarm fatigue among critical care nurses

a. Reference: Lewis, C.L., & Oster, C. A. (2019). Research outcomes of implementing CEASE: An innovative, nurse-driven, evidence-based, patient-customized monitoring bundle to decrease alarm fatigue in the intensive care unit/step-down unit. Dimensions of Critical Care Nursing, 38(3), 160-173.

b. Date of Publication: 2019

c. Authors: Carmencita Lorenzo and Cynthia Oster

d. Bias: Possible bias as both authors were, at the time of the study, nurse staff at the Porter Adventist Hospitals intensive care unit, where the study was conducted.

e. Precisely Completed: The study appears to have been precisely conducted, although the sample of 74 nurses was selected conveniently as opposed to randomly. Further, the study made use of the Clinical Alarms Survey of the Healthcare Technology Foundation to measure nurses adherence to the CEASE alarm bundle. The instrument has passed reliability tests, making it a credible measure and enhancing the reliability of the study findings.

f. Applicability: this document is applicable to the capstone project. The project seeks to reduce alarm fatigue among nurses. This document proves the effectiveness of the AACN CEASE alarm bundle, which is a combination of interventions, differently from other studies that focus on a single intervention. The CEASE tool enhances the monitoring of patients through a combination of interventions, including education on alarm systems, customizing alarm parameters, engaging appropriate monitoring parameters, changing ECG electrodes regularly, and suspending alarms that could produce false alarms during patient care.

g. Outcomes: The results of this study showed that implementation of the CEASE bundle decreased the number of daily alarms by 31 percent and the occurrence of nuisance alarms by 24 percent.

h. Comments and Grading: This being a quasi-experimental study, it falls…