How to Reduce Alarm Fatigue

CAPSTONE PROJECT SOURCES 2

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 study’s 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 project’s 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 than those in the control group. The results also showed a lower number of alarms and non-actionable alarms after the training among the experimental group as compared to the control group.

h. Comments and Grading: This document provides crucial insights on how alarm management training could be used to address alarm fatigue among nurses. It would be appropriate to replicate the study in multiple settings to test whether the results would remain the same. This being a randomized controlled trial, it falls under Level A of evidence, which is graded as high-quality evidence.

3. Effects of an alarm management program on alarm fatigue among ICU and telemetry registered nurses

a) Reference: Dee, S. A., Tucciarone, J., Plotkin, G., & Mallilo, C. (2022). Determining the impact of an alarm management program on alarm fatigue among ICU and telemetry RNs: An evidence-based research project. The Journal of School Nursing, 8(1), Doi: 10.1177/23779608221098713

b) Date of Publication: 2022

c) Authors: Dee Stacie, Tucciarone Jessica, Plotkin Gary, and Christina Mallilo

d) Bias: There was no apparent bias in this study

e) Precisely Completed: the study appears to have been precisely completed, although the findings would be more reliable if all the studies included in the evidence review were level A of evidence, such as randomized controlled trials and cohort studies. The authors used the Critical Appraisal Skills Programme Checklist (CASP) tool, which increased precision in the appraisal of selected articles.

f) Applicability: this document is very applicable to the capstone project as it lends credence to the effectiveness of an alarm management program as a strategy for reducing alarm fatigue among nurses.

g) Outcomes: Results of this document show that there is insufficient evidence to draw conclusions on the impact of an alarm management program based on the reviewed studies. However, based on the negative perceptions of nurses about alarm fatigue, the study assumes that implementing an alarm management system would lessen alarm fatigue.

h) Comments and Grading: Although this document does not provide a quantitative basis for the impact of an alarm management program, the six studies reviewed offer insights on the various initiatives that could be incorporated into an alarm management program in a clinical setting. This being a qualitative systematic review, it falls under level A of evidence, which can be graded as high quality evidence.

4. The Effect of Educational Interventions on Nurses’ Alarm Fatigue

a. Reference: Nyarko, B.A., Nie, H., Yin, Z., Chai, X., & Yue, L. (2022). The effect of educational interventions in managing nurses’ alarm fatigue: An integrative review. Journal of Clinical Nursing, 32(13), 2985-2997.

b. Date of Publication: 2022

c. Authors: Nyarko Brenda., Huiyu Nie, Yin Zengzen. Chai Xiaoya, and Yue Liqing.

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

e. Precisely Completed: The study appears to have been precisely completed. The researchers carried out an integrative review of literature using the PRISMA checklist, and subjected all the identified studies to a critical appraisal using the Joanna Briggs Institute level of evidence. A total of 13 studies were reviewed after meeting the inclusion criteria. However, precision could be improved by increasing the number of RCTs in the study to further test the effect of education programs on alarm fatigue.

f. Applicability: the document is applicable to the capstone project. The project focuses on ways of reducing alarm fatigue. This document provides evidence on the effectiveness of staff education programs in reducing alarm fatigue among nurses.

g. Outcomes: Results of this document show that educational interventions are beneficial in improving nurses’ perceptions and attitudes towards alarms, reducing false alarms and non-actionable alarms and improving alarm management practices among nurses. However, the results found that the effect of educational programs in reducing alarm fatigue was uncertain.

h. Comments and Grading: only two studies among those reviewed tested the impact of educational programs in reducing alarm fatigue. There may be a need for more RCTs and cohort studies to further test the effectiveness of these interventions in reducing alarm-related fatigue. Overall, the document was an integrative review, which includes both non-experimental and experimental studies. Thus, it could be categorized under level C of evidence, which is graded as moderate quality evidence.