JMIR Human Factors

Making health care interventions and technologies usable, safe, and effective

Transplant Cardiac ICU Nurses' Perceptions and Practices toward Clinical Alarms: Extending the 2011 Healthcare Technology Foundation’s Findings.

Background: Intensive care units (ICUs) are complex work environments where false alarms occur more frequently than on non-critical care units. The Joint Commission National Patient Safety Goal .06.01.01 targeted improving the safety of clinical alarm systems and required healthcare facilities to establish alarm systems safety as a hospital priority by July 2014 (Phase 1.A). An important initial step toward this requirement is identifying ICU nurses’ perceptions and common clinical practices toward clinical alarms, where little information is available. Objective: To determine perceptions and practices of transplant/cardiac ICU (TCICU) nurses toward clinical alarms and benchmark the results with the 2011 Healthcare Technology Foundation’s (HTF) Clinical Alarms Committee Survey. Methods: This descriptive study took place in a 20-bed TCICU, with 39 full and part time nurses. Nurses were surveyed about their perceptions and attitudes toward and practices on clinical alarms using the HTF survey. Results were compared to the 2011 HTF data. Correlations among variables were examined. Results: All TCICU nurses provided usable responses (N=39, 100%). Almost all nurses (95%- 98%) believed that false alarms are frequent, disrupt care, and reduce trust in alarm systems; causing nurses to inappropriately disable them. Unlike the 2011 HTF survey results, significantly higher percentages of our TCICU nurses believed that existing devices are complex, they questioned the ability and adequacy of the new monitoring systems to solve alarm management issues, pointed to the lack of prompt response to alarms, and indicated the lack of clinical policy on alarm management (P< .01). The major themes in the narrative data focused on nurses’ frustration related to the excessive number of alarms and poor usability of the cardiac monitors. The results also indicated a lack of standardized approaches in changing patients’ electrodes and individualizing parameters. Around 60% of the nurses indicated they received insufficient training on bedside and central cardiac monitors. A correlation also showed the need for training on cardiac monitors, specifically for older nurses (P= .01). Conclusions: False and non-actionable alarms continue to desensitize ICU nurses, which may result in missing fatal alarms. Nurses’ attitudes and practices related to clinical alarms are key in designing contextually sensitive quality initiatives to fight alarm fatigue. Alarm management in ICUs is a multi-dimensional complex process that involves usability of the monitoring devices, unit, clinicians, training, and policy-related factors. This indicates the need for a multimethod approach to decrease alarm fatigue and improve alarm systems safety.

2014-04-17

Announcing a New Journal: JMIR Human Factors JMIR Human Factors is a new spin-off journal of JMIR, the leading open access eHealth journal (Impact Factor 2010: 4.7). JMIR Human Factors is a multidisciplinary journal with contributions from medical researchers, engineers, and social scientists. JMIR Human Factors focuses on understanding how the behaviour and thinking of humans can influence and shape the design of health care interventions and technologies, and how the design can be evaluated and improved to make health care interventions and technologies usable, safe, and effective. We are currently soliciting papers for the inaugural issue - be a founding author of this new journal and submit your paper before 1. Dec 2014. All articles are professionally copyedited and typeset, ready for indexing in PubMed/PubMed Central. Possible contributions include usability studies and heuristic evaluations, studies concerning ergonomics and error prevention, design studies for medical devices and healthcare systems/workflows, enhancing teamwork through Human Factors based teamwork training, measuring non-technical skills in staff like leadership, communication, situational awareness and teamwork, and healthcare policies and procedures to reduce errors and increase safety. EDITORIAL BOARD MEMBERS ARE ALSO CURRENTLY BEING RECRUITED, PLEASE CONTACT jmir.editorial.office@gmail.com IF YOU ARE INTERESTED. Open Access *** No Submission Fees or Publication Fees humanfactors.jmir.org

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Journal Description

Announcing a New Journal:  JMIR Human Factors

JMIR Human Factors is a new spin-off journal of JMIR, the leading open access eHealth journal (Impact Factor 2013: 4.7). 

JMIR Human Factors is a multidisciplinary journal with contributions from medical researchers, engineers, and social scientists. JMIR Human Factors focuses on understanding how the behaviour and thinking of humans can influence and shape the design of health care interventions and technologies, and how the design can be evaluated and improved to make health care interventions and technologies usable, safe, and effective.

We are currently soliciting papers for the inaugural issue - be a founding author of this new journal and submit your paper before 1. October 2014. All articles are professionally copyedited and typeset, ready for indexing in PubMed/PubMed Central. Possible contributions include usability studies and heuristic evaluations, studies concerning ergonomics and error prevention, design studies for medical devices and healthcare systems/workflows, enhancing teamwork through Human Factors based teamwork training, measuring non-technical skills in staff like leadership, communication, situational awareness and teamwork, and healthcare policies and procedures to reduce errors and increase safety.

Submit your paper before October 1st, 2014 to be a founding author of this new journal.

Editorial Board members are currently being recruited, please contact us if you are interested (jmir.editorial.office at gmail.com).

 
Open Access *** No Submission Fees or Publication Fees

 
 

Recent Articles:

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  • Transplant Cardiac ICU Nurses' Perceptions and Practices toward Clinical Alarms: Extending the 2011 Healthcare Technology Foundation’s Findings.

    Date Submitted: Jan 10, 2015

    Open Peer Review Period: Jan 19, 2015 - Feb 2, 2015

    Background: Intensive care units (ICUs) are complex work environments where false alarms occur more frequently than on non-critical care units. The Joint Commission National Patient Safety Goal .06.01...

    Background: Intensive care units (ICUs) are complex work environments where false alarms occur more frequently than on non-critical care units. The Joint Commission National Patient Safety Goal .06.01.01 targeted improving the safety of clinical alarm systems and required healthcare facilities to establish alarm systems safety as a hospital priority by July 2014 (Phase 1.A). An important initial step toward this requirement is identifying ICU nurses’ perceptions and common clinical practices toward clinical alarms, where little information is available. Objective: To determine perceptions and practices of transplant/cardiac ICU (TCICU) nurses toward clinical alarms and benchmark the results with the 2011 Healthcare Technology Foundation’s (HTF) Clinical Alarms Committee Survey. Methods: This descriptive study took place in a 20-bed TCICU, with 39 full and part time nurses. Nurses were surveyed about their perceptions and attitudes toward and practices on clinical alarms using the HTF survey. Results were compared to the 2011 HTF data. Correlations among variables were examined. Results: All TCICU nurses provided usable responses (N=39, 100%). Almost all nurses (95%- 98%) believed that false alarms are frequent, disrupt care, and reduce trust in alarm systems; causing nurses to inappropriately disable them. Unlike the 2011 HTF survey results, significantly higher percentages of our TCICU nurses believed that existing devices are complex, they questioned the ability and adequacy of the new monitoring systems to solve alarm management issues, pointed to the lack of prompt response to alarms, and indicated the lack of clinical policy on alarm management (P< .01). The major themes in the narrative data focused on nurses’ frustration related to the excessive number of alarms and poor usability of the cardiac monitors. The results also indicated a lack of standardized approaches in changing patients’ electrodes and individualizing parameters. Around 60% of the nurses indicated they received insufficient training on bedside and central cardiac monitors. A correlation also showed the need for training on cardiac monitors, specifically for older nurses (P= .01). Conclusions: False and non-actionable alarms continue to desensitize ICU nurses, which may result in missing fatal alarms. Nurses’ attitudes and practices related to clinical alarms are key in designing contextually sensitive quality initiatives to fight alarm fatigue. Alarm management in ICUs is a multi-dimensional complex process that involves usability of the monitoring devices, unit, clinicians, training, and policy-related factors. This indicates the need for a multimethod approach to decrease alarm fatigue and improve alarm systems safety.