Challenges of customizing electrocardiography alarms in intensive care units: A mixed methods study
Kennedy, Holly Powell
Bonafide, Christopher P
AffiliationUniv Arizona, Coll Nursing
Critical Care Nursing
Intensive Care Units
Physiologic Monitor Alarms
MetadataShow full item record
CitationRuppel, H., Funk, M., Kennedy, H. P., Bonafide, C. P., Wung, S. F., & Whittemore, R. (2018). Challenges of customizing electrocardiography alarms in intensive care units: A mixed methods study. Heart & Lung, 47(5), 502-508.
JournalHEART & LUNG
Rights© 2018 Elsevier Inc. All rights reserved.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at email@example.com.
AbstractBackground: 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. (C) 2018 Elsevier Inc. All rights reserved.
Note12 month embargo; published online: 17 August 2018
VersionFinal accepted manuscript
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