Challenges of customizing ECG alarm settings in intensive care units: A mixed methods study
View File(s)
- Author(s)
- Details
-
Halley Ruppel, MS, RN, email: halley.ruppel@yale.edu; Marjorie Funk, PhD, RN, FAHA, FAAN, email: marjorie.funk@yale.edu; Holly Kennedy, PhD, CNM, FACNM, FAAN, email: holly.kennedy@yale.edu; Christopher Bonafide, MD, email: BONAFIDE@email.chop.edu; Shu-Fen Wung, PhD, MS, RN, ACNP-BC, FAAN, email: wung@email.arizona.edu; Robin Whittemore, PhD, APRN, FAAN, email: robin.whittemore@yale.edu
- Sigma Affiliation
- Delta Mu
Visitor Statistics
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Country | Visits |
---|
Top Visiting Cities
City | Visits |
---|
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Ruppel, Halley by View
Title | Page Views |
---|
Popular Works for Ruppel, Halley by Download
Title | Downloads |
---|
View Citations
Citations
Background: Alarm fatigue is a well-established patient safety concern in acute care settings. One mechanism for reducing this phenomenon and improving patient care is customization of alarm settings to reflect individual patient conditions.
Purpose: The purpose of this study was to generate an understanding of intensive care unit (ICU) nurses’ approach to customization of electrocardiography (ECG) alarms on the physiologic monitor, by describing their customization practices and exploring their clinical reasoning and judgment toward customization.
Methods: A convergent parallel mixed methods design was used. Three ICUs were included in the study. Quantitative data on types and frequency of alarms customized were collected from physiologic monitors and qualitative data on nurses’ customization practices were explored through interviews.
Results: Of the 298 monitors included in the study, 58.7% (n=175) had one or more alarm(s) customized. High and low heart rate limits, irregular heart rate, and atrial fibrillation were the most commonly customized alarm types. Qualitative findings demonstrated that customization practices varied widely among individual nurses, and many factors influenced their clinical reasoning, including level of clinical expertise, lack of structured customization education, and past negative experiences.
Conclusions: Practices, decisions, and comfort in customizing alarms varied and reflected individual characteristics of the nurses.
Sigma Theta Tau International Doris Bloch award; Connecticut Nurses Foundation; Halley Ruppel is a Robert Wood Johnson Foundation Future of Nursing Scholar
The Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.
Type | Research Study |
Acquisition | Self-submission |
Review Type | None: Sigma Grant Recipient Report |
Format | Text-based Document |
Evidence Level | Cross-Sectional |
Research Approach | Mixed/Multi Method Research |
Keywords | Intensive Care; Critical Care Nurses; ECG; Alarm Fatigue; Alarm Management |
CINAHL Subject(s) | Equipment Alarm Systems; Intensive Care Units; Critical Care Nursing; Monitoring, Physiologic; Electrocardiography; Patient Safety |
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
License
The following license files are associated with this item:
Related items
Showing items related by title, author, creator and subjects.
-
Reduced central line-associated bloodstream infection by application of integrated evidence-based care bundle in critically ill patients
Shiung, Tao-Fen; Lu, Shu-Fen; Chou, Shin-shang (2012-01-04)Central venous catheter-associated bloodstream infections (CBI) are frequent causes of morbidity and mortality in intensive care units (ICU). The purpose of this study is to apply an integrated evidence-based care bundle ... -
Improving clinical alarm fatigue and alarm management competency among critical care nurses by implementing a unit based alarm management bundle
Bosma, StephanieClinical alarms are designed to signal an unsatisfactory patient physiological state, alert staff to malfunctioning medical equipment or systems, and warn the operator of potential hazards to the patient. While alarms ... -
Impact of daily electrocardiographic electrode changes upon technical related cardiac monitor alarm events
Smith, Deborah H. (2017-09-21)Alarm fatigue occurs when excessive alarms cause nurses to disregard alarms posing a significant patient safety threat. This quality improvement project utilized the plan-do-check-act approach to examine the impact of daily ... -
Relationships between fatigue and depression in patients with coronary artery diseases (CAD)
Yeh, Wen-Ting; Su, Shu-FenThis study examined the relationships between fatigue and depression of Chinese patients with CAD.Age has a positive relationship with fatigue and depression. Fatigue was positively related to depression (0.662, p <0.01). ... -
Self-efficacy care model helps self-care efficacy and physical activity in older people with hip fracture
Su, Shu-Fen; Lin, Shu-Ni1.The self-efficacy Care Model (SCM) nursing intervention can significantly improve self-care efficacy of older patients after receiving hip fracture surgery. 2.The self-efficacy Care Model (SCM) nursing intervention can ...