Nurses' Alarm Fatigue Levels in Adult Intensive Care Units and Their Strategies to Reduce Fatigue: A Convergent Parallel Design

ABSTRACT

Background

Alarm fatigue is a challenge for nurses and patients. Also, feasible strategies to reduce/manage alarm fatigue are still unclear.

Aim

This study aimed to identify adult intensive care nurses' alarm fatigue levels and strategies to reduce alarm fatigue.

Design

A convergent parallel design was employed.

Method

The study was conducted between January and June 2022 in adult intensive care units of a university hospital, with 67 nurses in the quantitative phase and 14 in the qualitative phase. Quantitative data were collected using a personal information form, the Satisfaction Visual Analog Scale and the Nurses' Alarm Fatigue Questionnaire. Qualitative data were collected using a semi-structured interview form. Descriptive analyses, Mann–Whitney U, Kruskal–Wallis and Multiple Linear Regression analysis were used to evaluate quantitative data. The inductive content analysis method was utilised to evaluate qualitative data. The STROBE and COREQ checklists were employed to report the study.

Results

In the quantitative phase, increased intensive care unit working hours, available alarm management support for managing alarms, and increased satisfaction level were negatively associated with alarm fatigue. Three main themes (“building an alarm management culture”, “safe care environment” and “improving the features of alarm equipment/devices”) and 10 sub-themes were elicited from interview data about the reduction of alarm fatigue.

Conclusions

In the study, adult intensive care nurses' alarm fatigue levels and strategies to reduce fatigue were revealed. These strategies should be applied to reduce alarm fatigue in intensive care units.

Implications for Practice

Healthcare providers should develop and implement proactive strategies through effective organisational management to prevent and reduce alarm fatigue so that an alarm management culture can be built, employee satisfaction can be increased, a safe care environment can be provided, and the features of alarm devices can be improved.

Reporting Method

The study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) and Consolidated Criteria for Reporting Qualitative Research (COREQ) checklists.

Patient Contributions

No patient or public contribution.

Trial Registration

ClinicalTrials.gov identifier: NCT05163340