دورية أكاديمية
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Experiences and mediating factors in nurses' responses to electronic device alarms: A phenomenological study.

التفاصيل البيبلوغرافية
العنوان: Experiences and mediating factors in nurses' responses to electronic device alarms: A phenomenological study.
المؤلفون: López-Espuela F; Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain., Rodríguez-Martin B; Nursing, Physiotherapy and Occupational Therapy Department, Faculty of Health Sciences, University of Castilla la Mancha, Talavera de la Reina, Spain., Lavado García J; Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain., Toribio-Felipe R; Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain., Amarilla-Donoso FJ; Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain., Rodríguez Almagro JJ; Nursing, Physiotherapy and Occupational Therapy Department, Faculty of Health Sciences, University of Castilla la Mancha, Talavera de la Reina, Spain., Ribeiro ASF; Department of Health Sciences. San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, Madrid, Spain., Fernandes VS; Department of physiology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain., Moran-García JM; Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain.
المصدر: Journal of nursing management [J Nurs Manag] 2022 Jul; Vol. 30 (5), pp. 1303-1316. Date of Electronic Publication: 2022 Apr 22.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Blackwell Scientific Publications Country of Publication: England NLM ID: 9306050 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2834 (Electronic) Linking ISSN: 09660429 NLM ISO Abbreviation: J Nurs Manag
أسماء مطبوعة: Original Publication: Oxford : Blackwell Scientific Publications, c1993-
مواضيع طبية MeSH: Clinical Alarms* , Nurses*, Electronics ; Humans ; Male ; Mediation Analysis ; Monitoring, Physiologic
مستخلص: Aim: This study aims to explore the experiences and mediating factors of nurses' responses to electronic device alarms in critical care units (CCUs).
Background: Alarm fatigue occasionally has adverse consequences for patient safety.
Methods: This qualitative study was designed and analysed following Giorgi's descriptive phenomenological approach. Seventeen nurses were theoretically sampled, reaching information saturation. Semistructured interviews were used to collect the data.
Results: Three central themes explained nurses' experiences: general perceptions about alarms (basic equipment of the CCU), strategies to reduce false alarms (training in the configuration of monitors, customization of the alarms to fit he patient's condition. teamwork and taking advantage of the development of technology) and key elements of the response to alarms (information about patient's condition, nurses' clinical experience, type of CCU, 'cry-wolf' phenomenon and nurse/patient ratio).
Conclusions: To reduce false alarms, nurses need further postgraduate training, training on monitors and customizing alarms to fit the patient's health status. The complex process of deciding to respond to an alarm includes environmental, professional variables and patient status.
Implications for Nursing Management: Nurse managers should ensure that nurses have sufficient experience and training in the CCU, improve the nurse/patient ratio, promote teamwork and ensure that the devices are the latest generation.
(© 2022 John Wiley & Sons Ltd.)
References: American Association of Critical-Care Nurses. (2018). Managing alarms in acute care across the life span: Electrocardiography and pulse oximetry. Critical Care Nurse, 38(2), e16-e20. https://doi.org/10.4037/ccn2018468.
Areia, C., Biggs, C., Santos, M., Thurley, N., Gerry, S., Tarassenko, L., Watkinson, P., & Vollam, S. (2021). The impact of wearable continuous vital sign monitoring on deterioration detection and clinical outcomes in hospitalised patients: A systematic review and meta-analysis. Critical Care, 25(1), 351. https://doi.org/10.1186/s13054-021-03766-4.
Boeije, H. (2002). A purposeful approach to the constant comparative method in the analysis of qualitative interviews. Quality and Quantity, 36(4), 391-409. https://doi.org/10.1023/A:1020909529486.
Bollepalli, S. C., Sevakula, R. K., Au-Yeung, W. M., Kassab, M. B., Merchant, F. M., Bazoukis, G., Boyer, R., Isselbacher, E. M., & Armoundas, A. A. (2021). Real-time arrhythmia detection using hybrid convolutional neural networks. Journal of the American Heart Association, 10(23), e023222. https://doi.org/10.1161/JAHA.121.023222.
Brantley, A., Collins-Brown, S., Kirkland, J., Knapp, M., Pressley, J., Higgins, M., & McMurtry, J. P. (2016). Clinical trial of an educational program to decrease monitor alarms in a medical intensive care unit. AACN Advanced Critical Care, 27(3), 283-289. https://doi.org/10.4037/aacnacc2016110.
Casey, S., Avalos, G., & Dowling, M. (2018). Critical care nurses' knowledge of alarm fatigue and practices towards alarms: A multicentre study. Intensive & Critical Care Nursing, 48, 36-41. https://doi.org/10.1016/j.iccn.2018.05.004.
Cho, O. M., Kim, H., Lee, Y. W., & Cho, I. (2016). Clinical alarms in intensive care units: Perceived obstacles of alarm management and alarm fatigue in nurses. Healthcare Informatics Research, 1, 46-53. https://doi.org/10.4258/hir.2016.22.1.46.
Claudio, D., Deb, S., & Diegel, E. (2021). A framework to assess alarm fatigue indicators in critical care staff. Critical Care Explorations, 3(6), e0464. https://doi.org/10.1097/CCE.0000000000000464.
Darbyshire, J. L., & Young, J. D. (2013). An investigation of sound levels on intensive care units with reference to the WHO guidelines. Critical Care, 17(5), R187. https://doi.org/10.1186/cc12870.
Despins, L. A. (2017). Factors influencing when intensive care unit nurses go to the bedside to investigate patient related alarms: A descriptive qualitative study. Intensive & Critical Care Nursing, 43, 101-107. https://doi.org/10.1016/j.iccn.2017.04.003.
Emergency Care Research Institute. (2020). Top 10 health technology hazards for 2020. Health Devices. 2020. Available online: https://elautoclave.files.wordpress.com/2019/10/ecri-top-10-technology-hazards-2020.pdf (Accessed 20.10.21).
Englander, M. (2012). The interview: Data collection in descriptive phenomenological human scientific research. Journal of Phenomenological Psychology, 43, 13-35. https://doi.org/10.1163/156916212X632943.
Fernandes, C., Miles, S., & Lucena, C. J. (2020). Detecting false alarms by analyzing alarm-context information: Algorithm development and validation. JMIR Medical Informatics, 8(5), e15407. https://doi.org/10.2196/15407.
Freysdóttir, G. R., Björnsdóttir, K., & Svavarsdóttir, M. H. (2019). Nurses' use of monitors in patient surveillance: An ethnographic study on a coronary care unit. European Journal of Cardiovascular Nursing, 18(4), 272-279. https://doi.org/10.1177/1474515118816930.
Gazarian, P. K., Carrier, N., Cohen, R., Schram, H., & Shiromani, S. (2015). A description of nurses' decision-making in managing electrocardiographic monitor alarms. Journal of Clinical Nursing, 24(1-2), 151-159. https://doi.org/10.1111/jocn.12625.
Gentles, S. J., Charles, C., Ploeg, J., & McKibbon, K. A. (2015). Sampling in qualitative research: Insights from an overview of the methods literature. The Qualitative Report, 20(11), 1772-1789. https://doi.org/10.46743/2160-3715/2015.2373.
Giorgi, A. (2009). The descriptive phenomenological method in psychology: A modified Husserlian approach. Duquesne University Press.
Guba, E. G., & Lincoln, Y. S. (1989). Fourth generation evaluation. Sage.
Hyland, S. L., Faltys, M., Hüser, M., Lyu, X., Gumbsch, T., Esteban, C., Bock, C., Horn, M., Moor, M., Rieck, B., Zimmermann, M., Bodenham, D., Borgwardt, K., Rätsch, G., & Merz, T. M. (2020). Early prediction of circulatory failure in the intensive care unit using machine learning. Nature Medicine, 26(3), 364-373. https://doi.org/10.1038/s41591-020-0789-4.
Jeong, Y. J., & Kim, H. (2022). Critical care nurses' perceptions and practices towards clinical alarms. Nursing in Critical Care. https://doi.org/10.1111/nicc.12751.
Johnson, K. R., Hagadorn, J. I., & Sink, D. W. (2017). Alarm safety and alarm fatigue. Clinics in Perinatology, 44(3), 713-728. https://doi.org/10.1016/j.clp.2017.05.005.
Lewandowska, K., Weisbrot, M., Cieloszyk, A., Mędrzycka-Dąbrowska, 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. https://doi.org/10.3390/ijerph17228409.
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. https://doi.org/10.1097/DCC.0000000000000357.
Manzey, D., Gérard, N., & Wiczorek, R. (2014). Decision-making and response strategies in interaction with alarms: The impact of alarm reliability, availability of alarm validity information and workload. Ergonomics, 57(12), 1833-1855. https://doi.org/10.1080/00140139.2014.957732.
McKenzie, R., Miller, S., Cope, V., & Brand, G. (2021). Transition experiences of newly qualified registered graduate nurses employed in a Neonatal Intensive Care Unit. Intensive & Critical Care Nursing, 67, 103112. https://doi.org/10.1016/j.iccn.2021.103112.
Meng'anyi, L. W., Omondi, L. A., & Muiva, M. N. (2017). Assessment of nurses interventions in the Management of Clinical Alarms in the critical care unit, Kenyatta National Hospital, a cross sectional study. BMC Nursing, 16, 41. https://doi.org/10.1186/s12912-017-0235-1.
Mirhafez, S. R., Movahedi, A., Moghadam-Pasha, A., Mohammadi, G., Moeini, V., Moradi, Z., Kavosi, A., & Aryayi Far, M. (2019). Perceptions and practices related to clinical alarms. Nursing Forum, 54(3), 369-375. https://doi.org/10.1111/nuf.12338.
Muroi, C., Meier, S., De Luca, V., Mack, D. J., Strässle, C., Schwab, P., Karlen, W., & Keller, E. (2020). Automated false alarm reduction in a real-life intensive care setting using motion detection. Neurocritical Care, 32(2), 419-426. https://doi.org/10.1007/s12028-019-00711-w.
Pater, C. M., Sosa, T. K., Boyer, J., Cable, R., Egan, M., Knilans, T. K., Schondelmeyer, A. C., Schuler, C. L., & Madsen, N. L. (2020). Time series evaluation of improvement interventions to reduce alarm notifications in a paediatric hospital. BMJ Quality and Safety, 29(9), 717-726. https://doi.org/10.1136/bmjqs-2019-010368.
Phillips, J., Sowan, A., Ruppel, H., & Magness, R. (2020). Educational program for physiologic monitor use and alarm systems safety: A toolkit. Clinical Nurse Specialist, 34(2), 50-62. https://doi.org/10.1097/NUR.0000000000000507.
Poncette, A. S., Spies, C., Mosch, L., Schieler, M., Weber-Carstens, S., Krampe, H., & Balzer, F. (2019). Clinical requirements of future patient monitoring in the intensive care unit: Qualitative study. JMIR Medical Informatics, 7(2), e13064. https://doi.org/10.2196/13064.
Ruppel, H., De Vaux, L., Cooper, D., Kunz, S., Duller, B., & Funk, M. (2018). Testing physiologic monitor alarm customization software to reduce alarm rates and improve nurses' experience of alarms in a medical intensive care unit. PLoS ONE, 13(10), e0205901. https://doi.org/10.1371/journal.pone.0205901.
Ruppel, H., Funk, M., Clark, J. T., Gieras, I., David, Y., Bauld, T. J., Coss, P., & Holland, M. L. (2018). Attitudes and practices related to clinical alarms: A follow-up survey. American Journal of Critical Care, 27(2), 114-123. https://doi.org/10.4037/ajcc2018185.
Ruppel, H., Funk, M., Whittemore, R., Wung, S. F., Bonafide, C. P., & Powell Kennedy, H. (2019). Critical care nurses' clinical reasoning about physiologic monitor alarm customisation: An interpretive descriptive study. Journal of Clinical Nursing, 28(15-16), 3033-3041. https://doi.org/10.1111/jocn.14866.
Ruskin, K. J., & Hueske-Kraus, D. (2015). Alarm fatigue: Impacts on patient safety. Current Opinion in Anaesthesiology, 28(6), 685-690. https://doi.org/10.1097/ACO.0000000000000260.
Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B., Burroughs, H., & Jinks, C. (2018). Saturation in qualitative research: Exploring its conceptualization and operationalization. Quality and Quantity, 52(4), 1893-1907. https://doi.org/10.1007/s11135-017-0574-8.
Schondelmeyer, A. C., Daraiseh, N. M., Allison, B., Acree, C., Loechtenfeldt, A. M., Timmons, K. M., Mangeot, C., & Brady, P. W. (2019). Nurse responses to physiologic monitor alarms on a general pediatric unit. Journal of Hospital Medicine, 14(10), 602-606. https://doi.org/10.12788/jhm.3234.
Simpson, K. R., & Lyndon, A. (2019). False alarms and overmonitoring: major factors in alarm fatigue among labor nurses. Journal of Nursing Care Quality, 34(1), 66-72. https://doi.org/10.1097/NCQ.0000000000000335.
Sowan, A. K., Vera, A. G., Fonseca, E. I., Reed, C. C., Tarriela, A. F., & Berndt, A. E. (2017). Nurse competence on physiologic monitors use: toward eliminating alarm fatigue in intensive care units. The Open Medical Informatics Journal, 11, 1-11. https://doi.org/10.2174/1874431101711010001.
Stewart, C. (2021). Understanding new nurses' learning experiences in intensive care. Intensive & Critical Care Nursing, 67, 103094. https://doi.org/10.1016/j.iccn.2021.103094.
Storm, J., & Chen, H. C. (2021). The relationships among alarm fatigue, compassion fatigue, burnout and compassion satisfaction in critical care and step-down nurses. Journal of Clinical Nursing, 30(3-4), 443-453. https://doi.org/10.1111/jocn.15555.
The Joint Commission. (2020). National patient safety goals effective January 2020. Hospital Accreditation Program. https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/2020-hap-npsg-goals-final.pdf (Accessed 2.11.2021).
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349-357. https://doi.org/10.1093/intqhc/mzm042.
Unal, A., Arsava, E. M., Caglar, G., & Topcuoglu, M. A. (2021). Alarms in a neurocritical care unit: A prospective study. Journal of Clinical Monitoring and Computing, 27, 1-7. https://doi.org/10.1007/s10877-021-00724-x.
Wilken, M., Hüske-Kraus, D., & Röhrig, R. (2019). Alarm fatigue: Using alarm data from a patient data monitoring system on an intensive care unit to improve the alarm management. Studies in Health Technology and Informatics, 267, 273-281. https://doi.org/10.3233/SHTI190838.
Willig, C., & Rogers, W. S. (Eds.) (2017). The SAGE handbook of qualitative research in psychology. Sage. https://doi.org/10.4135/9781526405555.
Yue, L., Plummer, V., & Cross, W. (2017). The effectiveness of nurse education and training for clinical alarm response and management: A systematic review. Journal of Clinical Nursing, 26(17-18), 2511-2526. https://doi.org/10.1111/jocn.13605.
معلومات مُعتمدة: European Union; PI16/01741 Institute Carlos III
فهرسة مساهمة: Keywords: clinical alarms; critical care unit; fatigue alarm; management alarm; nursing; patient safety
تواريخ الأحداث: Date Created: 20220411 Date Completed: 20220706 Latest Revision: 20220706
رمز التحديث: 20240628
DOI: 10.1111/jonm.13614
PMID: 35403277
قاعدة البيانات: MEDLINE
الوصف
تدمد:1365-2834
DOI:10.1111/jonm.13614