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Challenges of customizing electrocardiography alarms in intensive care units: A mixed methods study.
Ruppel, Halley; Funk, Marjorie; Kennedy, Holly Powell; Bonafide, Christopher P; Wung, Shu-Fen; Whittemore, Robin.
Affiliation
  • Ruppel H; School of Nursing, Yale University, P.O. Box 27399, West Haven, CT, 06516-7399, United States. Electronic address: halley.ruppel@yale.edu.
  • Funk M; School of Nursing, Yale University, P.O. Box 27399, West Haven, CT, 06516-7399, United States.
  • Kennedy HP; School of Nursing, Yale University, P.O. Box 27399, West Haven, CT, 06516-7399, United States.
  • Bonafide CP; Children's Hospital of Philadelphia and University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104-4399, United States.
  • Wung SF; College of Nursing, The University of Arizona, 1305 North Martin Avenue, Tucson, AZ, 85721-0203, United States.
  • Whittemore R; School of Nursing, Yale University, P.O. Box 27399, West Haven, CT, 06516-7399, United States.
Heart Lung ; 47(5): 502-508, 2018.
Article in En | MEDLINE | ID: mdl-30122549
ABSTRACT

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.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Practice Patterns, Physicians' / Electrocardiography / Clinical Alarms / Monitoring, Physiologic Type of study: Prognostic_studies / Qualitative_research Limits: Adult / Female / Humans / Male Language: En Journal: Heart Lung Year: 2018 Document type: Article
Fulltext
Add to My VHL
Print
XML
PubMed Links
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Practice Patterns, Physicians' / Electrocardiography / Clinical Alarms / Monitoring, Physiologic Type of study: Prognostic_studies / Qualitative_research Limits: Adult / Female / Humans / Male Language: En Journal: Heart Lung Year: 2018 Document type: Article