ASSESSMENT OF ALARM FATIGUE, RESPONSE TIME AND PATIENT SAFETY PERCEPTION AMONG ICU NURSES
Main Article Content
Keywords
Alarm fatigue, ICUs, Response time, Patient safety perception, Alarm-management practices, Clinical alarms, ICU workload, Nursing workload
Abstract
Background: Clinical alarm systems used to monitor changes in patients' condition in intensive care units are crucial. But if the alarms are continually false, not actionable and repetitive, this can cause alarm fatigue among ICU Nurses. Ineffective attention to alarms, response times and potentially patient safety can all be impacted by alarm fatigue. Hence, it is important to understand how relying on alarm fatigue, response time, alarm management practices and perception of patient safety are related to improve nurse performance and outcomes.
Objective: The purpose of this study was to determine the awareness of alarm fatigue,reaction time to alarm, alarm management and perception of patient safety among ICU nurses.Differences due to training, working shifts and patient load were also analysed, as well as the relationships and predictive effect between the main study variables.
Methods: A structured questionnaire was used to gather the data, which comprised 204 ICU nurses. For statistical analyses, normality tests were conducted using the Shapiro-Wilk test,reliability test (Cronbach's alpha) and validity test (KMO and Bartlett's test). The data were analysed with the independent-samples $t$ test, one-way ANOVA, Kruskal-Wallis test,chi-square test of independence, Pearson correlation and multiple linear regression. A p-value oo<0.05 was used as the cut-off value for statistical significance.
Results: The results of the questionnaire had high reliability and construct validity; all study variables were normally distributed. The trained nurse had a significantly better response time compared to the untrained nurse. The alarm-fatigue scores were statistically significantly different between the different patient-assignment groups and also between the fatigue scores of both work shifts. Also, alarm training was highly correlated wwith the performance in response time.All scale measures showed statistically significant positive relationships with each other for Alarm Fatigue, Response Time, Patient Safety Perception and Alarm Management Practices.Statistically this model was significant, explaining 54.9%o of the variance of this model about the patient safety perception. Alarm Fatigue and Response Time were positive significant predictors for the practices.
Conclusion: Alarm-related training, workload, the state of the shift, and the practices in alarm management have significant effects on nurses' response performance and patient safety perception is stated. In an intensive care unit environment, alarm fatigue may not assist in patient safety measures and may lead to the potential for unnecessary alarms if adequate alarm response,staffing and training are not put in place. The use of the correct alarm, the right training, staffing and response for the correct alarm and minimising unnecessary alarms is the correct way to prevent alarm fatigue in the intensive care unit to improve patient safety.
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