Alarms Cause Worry and Stress.
Nurses in adult ICUs and NICUs reported changing clinical alarm parameters based on pa- tient condition to minimize false alarms and therefore the potential for alarm fatigue, while labor nurses indicated this was not a common practice. “We usually set our parameters for heart rate, respiratory rate, blood pressure, all sorts of things like that depending on patients’ condition and what protocol they are on” (ICU nurse); “You can choose your alarm limit; set your heart and respiratory rate limits. It’s my patient and I’m responsible for the parameters” (NICU nurse); and “Some of the parameters that are set with these alarms don’t make sense because it’s normal for a baby to be above 160 [bpm, beats per minute] for a minute because the baby is moving around. We don’t set [alarm] pa- rameters” (labor nurse).
Impact of alarms on patients and families Nurses in all specialties were concerned about the impact of alarms on patients and families. They acknowledged alarms caused worry and stress. “Is something wrong with our baby? I’ve had patients ask that all the time” (labor nurse). “Visitors get upset that you’re not re- sponding to the alarms quick enough, but we know there is nothing wrong”(ICU nurse). How- ever, over time, nurses noted that patients’ fam- ilies adjust and develop resilience to the early stress of the alarms. “Initially parents are terri- fied of every alarm that goes off, and they stare at their baby. After a couple of weeks, they’ll have visitors and say, ‘Oh don’t worry about it.’” (NICU nurse). “Patients’ families watch you, and they see you hit the silence button. The next thing you know, you’re thinking, ‘I haven’t heard an alarm in there for a while,’ and families are in there silencing your alarms” (ICU nurse). Labor nurses likewise reported family mem- bers silencing alarms without letting the nurse know.
Nurses mentioned patient education and ex- planations about alarms as a way to minimize patient concerns and reduce anxiety.
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