TY  - JOUR
AU  - Mosch, Lina
AU  - Sümer, Meltem
AU  - Flint, Anne Rike
AU  - Feufel, Markus
AU  - Balzer, Felix
AU  - Mörike, Frauke
AU  - Poncette, Akira-Sebastian
PY  - 2024
DA  - 2024/6/18
TI  - Alarm Management in Intensive Care: Qualitative Triangulation Study
JO  - JMIR Hum Factors
SP  - e55571
VL  - 11
KW  - digital health
KW  - transdisciplinary research
KW  - technological innovation
KW  - patient-centered care
KW  - qualitative
KW  - ethnographic
KW  - ethnography
KW  - intensive care unit
KW  - ICU
KW  - intensive care
KW  - German
KW  - Germany
KW  - Europe
KW  - European
KW  - interview
KW  - interviews
KW  - alarm
KW  - alarms
KW  - intelligent
KW  - artificial intelligence
KW  - grounded theory
KW  - experience
KW  - experiences
KW  - attitude
KW  - attitudes
KW  - opinion
KW  - opinions
KW  - perception
KW  - perceptions
KW  - perspective
KW  - perspectives
AB  - Background: The high number of unnecessary alarms in intensive care settings leads to alarm fatigue among staff and threatens patient safety. To develop and implement effective and sustainable solutions for alarm management in intensive care units (ICUs), an understanding of staff interactions with the patient monitoring system and alarm management practices is essential. Objective: This study investigated the interaction of nurses and physicians with the patient monitoring system, their perceptions of alarm management, and smart alarm management solutions. Methods: This explorative qualitative study with an ethnographic, multimethods approach was conducted in an ICU of a German university hospital. Using triangulation in data collection, 102 hours of field observations, 12 semistructured interviews with ICU staff members, and the results of a participatory task were analyzed. The data analysis followed an inductive, grounded theory approach. Results: Nurses and physicians reported interacting with the continuous vital sign monitoring system for most of their work time and tasks. There were no established standards for alarm management; instead, nurses and physicians stated that alarms were addressed through ad hoc reactions, a practice they viewed as problematic. Staff members’ perceptions of intelligent alarm management varied, but they highlighted the importance of understandable and traceable suggestions to increase trust and cognitive ease. Conclusions: Staff members’ interactions with the omnipresent patient monitoring system and its alarms are essential parts of ICU workflows and clinical decision-making. Alarm management standards and workflows have been shown to be deficient. Our observations, as well as staff feedback, suggest that changes are warranted. Solutions for alarm management should be designed and implemented with users, workflows, and real-world data at the core. 
SN  - 2292-9495
UR  - https://humanfactors.jmir.org/2024/1/e55571
UR  - https://doi.org/10.2196/55571
UR  - http://www.ncbi.nlm.nih.gov/pubmed/38888941
DO  - 10.2196/55571
ID  - info:doi/10.2196/55571
ER  -