Challenges of customizing electrocardiography alarms in intensive care units: A mixed methods study
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Ruppel, HalleyFunk, Marjorie
Kennedy, Holly Powell
Bonafide, Christopher P
Wung, Shu-Fen
Whittemore, Robin
Affiliation
Univ Arizona, Coll NursingIssue Date
2018Keywords
Alarm CustomizationClinical Alarms
Critical Care Nursing
Electrocardiography
Intensive Care Units
Physiologic Monitor Alarms
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MOSBY-ELSEVIERCitation
Ruppel, 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.Journal
HEART & LUNGRights
© 2018 Elsevier Inc. All rights reserved.Collection Information
This 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 repository@u.library.arizona.edu.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. (C) 2018 Elsevier Inc. All rights reserved.Note
12 month embargo; published online: 17 August 2018ISSN
0147-9563PubMed ID
30122549Version
Final accepted manuscriptae974a485f413a2113503eed53cd6c53
10.1016/j.hrtlng.2018.06.010
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