Alarm fatigue is a sensory overload that results when nurses are exposed to many alarms such that they develop desensitization towards vital alarms. As a result, many deaths may be reported due to the lack of perception of alarms that alert emergencies in the hospital. According to recent studies, most of the alarms in hospitals are false. Nurses and other health care providers have ended up recognizing all alarms as false, and so they are rarely shaken by any strange alarms that come from machines in the hospital. Although extensive researches have been done on the issue of alarm fatigue, more research is needed to come up with appropriate and evidence-based approaches to cope with it.
Studying this topic is important in different ways. Firstly, it enables one to develop more knowledge concerning alarm fatigue. Besides, it enables one to discover the available approaches to reduce alarm fatigue among nurses in hospitals. With adequate knowledge about alarm fatigue and the available preventive approaches, health care practitioners can prevent many deaths that result from this problem by taking charge of all alarms in the hospital. This includes false and emergency-alerting alarms.
As such, the major purpose of this paper is to carry out adequate research regarding alarm fatigue in nursing, including a valid description of the issue, causes, and its impact on nursing roles and interventions. In this case, nursing roles entail the major activities carried out by nurses that may be affected by alarm fatigue.
Description of Alarm Fatigue
As shown earlier, alarm fatigue results due to desensitization of the nurses’ brains towards many alarms in hospitals. According to the recent studies, 72 to 99% of alarms in the heard in the hospital are false (Weindorf, Payne, Eckberg, & Eckberg, 2015). Since nurses spend most of their time in the facilities, they get used to those many alarms such that they cannot differentiate between emergency-alerting alarms and false. Besides, all alarms in hospitals result from machines that perform similar functions. Therefore, it is likely for machines that are powered and not connected to patients to produce similar sounds as those connected to patients. For instance, dialysis machines in the renal unit are always connected in advance so that it can be convenient to connect them to patients who present with emergent renal problems. While in the renal unit, one can hear almost ten sounds at a time, depending on the number of dialysis machines connected to patients and those waiting for patients. In this case, it is difficult to identify an alarm indicating an emergent case and many death may be witnessed if nurses do not monitor patients continuously.
Besides, common machines in hospitals such as blood pressure machines, ventilators, heart monitors, and temperature monitors produce random sounds which stick in the nurses’ minds (Sowan, Tarriela, Gomez, Reed, & Rapp, 2015). Some of these sounds are similar, and nurses fail to differentiate between sounds from heart monitors and blood pressure machines. As such, they may hear an alert from a patient with a heart problem and ignore it thinking that it is a mere sound from a blood pressure machine. In the end, the patient may die due to uncontrolled heartbeats and sounds. Such cases have been experienced several in different hospitals, and the cause has been associated with alarm sickness among nurses.
Even though the problem of alarm fatigue seems to be continuous, studies have been carried out by different patient safety and regulatory agencies including the Joint for Patient Safety Commission. Following those studies, adjustments have been done in the healthcare sector to help nurse heal from alarm fatigue. For example, machines in hospitals have been adjusted in a way that they do not make multiple sounds without a key trigger such as emergent cases happening on patients. Also, customization of sounds of different machines has been done to ensure that nurses get to understand the meaning of every sound being produced by machines in the hospital. Damaged machines that produce random sound have as well been repaired so that they can stop causing confusion to nurses while caring for patients. Still, these changes to avoid alarm fatigue have not been implemented in all facilities. Besides, even those have implemented the changes keep on experiencing problems related to alarm fatigue such as random deaths. Thus, more research is needed to come up with evidence-based approaches to eliminate the condition and its impacts on patients.
Causes of Alarm Fatigue in Nursing
Alarm fatigue is majorly caused by random sounds of different machines in the hospital. Such machines include dialysis machines, heart monitors, blood pressure machines, and ventilators among others. In cases where these machines are well controlled and maintained cases of alarm fatigue. Major effects arise when the machines are allowed to make many sounds continuously. As hinted earlier, nurses who spend their time in the hospital get desensitized to the noisy machines such that they cannot differentiate between sounds that indicate danger to patients from false sounds.
Among the mentioned machines, those that are connected to electrical sources such as dialysis machines and cardiac monitors cause most of the cases of alarm fatigue. Such machines tend to make progressive sounds as long as they are powered with electricity. As a result, nurses who spend their time near such machines get used to their sounds to the extent of not identifying any strange thing when they notice them making uncommon sounds. On the other hand, other common machines such as blood pressure and temperature machines make false sounds, especially when their batteries fail to function due to reaching expiry dates (Casey, Avalos, & Dowling, 2018). In most hospital machines with exhausted batteries are ignored and left to make continuous sounds. In this case, a problem comes when they make similar sounds to other machines that are connected to patients with threatening conditions. Nurses may assume that the sounds are coming from the exhausted machines only to realize when it is late that they were coming from the machine connected to the patients. Most of the deaths resulting from such cases of ignorance.
Lastly, alarm fatigue can result when machines continuously make sounds even when there are no accompanying complications to the patient. For instance, dialysis machines are prone to making sounds even when they are functioning normally. In this regards, the false sounds collide with tragedy-alerting sounds and nurses may fail to recognize the odd sounds. Since these machines are usually connected to patients, their chances of causing death are high. Nurses rarely identify exclusive sounds indicating emergency cases among patients.
Impact of Alarm Fatigue on Nurses’ Roles/Interventions
There are many roles and interventions that nurses perform in the hospital to ensure that patients recover to a state of wellness. Some of the major roles of nurses include taking patient history, collaborating with other health care team members, performing diagnostic tests, and monitoring patient health and recording vital signs. All these roles and interventions can be carried out successfully if nurses reach their patients from time to time. However, alarm fatigue can impair the nurses’ ability to perform those roles and interventions. This is because it prevents nurses from coming in contact with patients at the scheduled time or when there is a threatening situation.
First of all, alarm fatigue prevents nurses from taking the correct history from patients before implementing their care. In some cases, they fail to recognize important alerts showing changes in the patients’ symptoms. For example, they may fail to recognize a rise in the heartbeat or blood pressure due to the inability to differentiate false alarms from emergency-alerting alarms. At last, they end up recording unreliable data and history that is not dependable why treating patients. Secondly, alarm fatigue prevents nurses from collaborating with other health care team members such as physicians in providing care to patients. Nurses spend most of their time in the hospital so that they can monitor patients’ progress by listening and responding to alarms. In this situation, they are unable to sense alarms that indicate an emergency. Therefore, it will be difficult for them to report to other collaborative team members concerning patients’ progress. As a result, patients end up dying due to ineffective collaborative team management.
More so, alarm fatigue prevents nurses from performing diagnostic tests that should be known for better management of patients. Generally, nursing and medical diagnoses are based on the patients’ response to interventions. Healthcare monitoring machines such as thermometers, blood pressure machines, and dialysis machines are used to measure and regulate symptoms of patients in the hospital (Wilken et al., 2017). In case of any abnormalities in the patients’ health status, the machines mentioned above respond by raising the alarm in the form of sounds. However, nurses suffering from alarm fatigue cannot take part in making such diagnostic tests since they might fail to recognize unique sounds from diagnostic machines.
Another important role of nurses that can be highly affected by alarm fatigue is monitoring patients’ progress and taking vital signs. Monitoring involves ensuring that patients do not develop negative symptoms during treatment. It is normally done through measuring vital signs including temperature, pulse, blood pressure, oxygen saturation, and respiration among others. In developed healthcare facilities, computerized machines are used to monitor vital signs. Thus, nurses are supposed to keep watch on those machines to identify any abnormities in patients’ symptoms. Like other machinery equipment in hospitals, computerized machinery has alarms that help nurses check for vital signs that are out of range. In the case of nurses suffering from alarm fatigue, it is difficult for them to monitor vital signs on computerized machines (Turmell, Coke, Catinella, Hosford, & Majeski, 2017). They may end up ignoring critical cases which may cause patient deaths.
In essence, alarm fatigue disrupts all areas of functioning for nurses including total nursing and critical care of patients. Hospitals with nurses having this condition are likely to experience frequent deaths due to the inadequate performance of the roles discussed above.
Based on the discussion above, alarm fatigue is a major condition affecting nurses in providing comprehensive care to patients in hospitals. As shown before, about 72 to 99% of alarms in hospitals are false alarms. The high rate of false alarms provokes nurses to believe that all alarms coming from machines are false alarms. As a result, many patients connected to monitoring machines end up dying due to abnormal symptoms. Apart from causing abrupt deaths to patients having critical conditions, alarm fatigue poses negative impacts on nurses’ performance of their functions. Such roles include taking patient history, monitoring patient progress, making diagnoses, and collaborating with other health care team members. In short, alarm fatigues all areas of functioning for nurses.
The continuous negative impacts resulting from alarm fatigue means that appropriate and evidence-based approaches should be initiated to enable nurses to prevent and avoid alarm fatigue. As shown before, the Joint Commission did research and came up with evidence-based approaches that can help nurses cope with alarm fatigue. Such measures include customization of electronic parameters that produce sounds, repairing noisy machines, and educating nurses on measures to avoid alarm fatigue. Although these have been implemented in some health facilities, cases of patient deaths due to alarm fatigue have been reported. This means that more research should be done concerning alarm fatigue to help nurses cope with it completely.
In short, health-related agencies should collaborate with nurses to ensure that alarm fatigue is eliminated among nurses in different health care facilities. Besides, efforts should be done in hospitals to ensure that all machines that promote alarm fatigue are repaired. By doing this, deaths resulting from alarm fatigue among nurses will decrease, and nurses will perform their roles appropriately.
Casey, S., Avalos, G., & Dowling, M. (2018). Critical care nurses’ knowledge of alarm fatigue and practices towards alarms: a multicentre study. Intensive and Critical Care Nursing, 48, 36-41.
Sowan, A. K., Tarriela, A. F., Gomez, T. M., Reed, C. C., & Rapp, K. M. (2015). Nurses’ perceptions and practices toward clinical alarms in a transplant cardiac intensive care unit: Exploring key issues leading to alarm fatigue. JMIR human factors, 2(1).
Turmell, J. W., Coke, L., Catinella, R., Hosford, T., & Majeski, A. (2017). Alarm fatigue: use of an evidence-based alarm management strategy. Journal of nursing care quality, 32(1), 47-54.
Weindorf, G., Payne, J., Eckberg, J., & Eckberg, H. (2015). Alarm Fatigue.
Wilken, M., Hüske-Kraus, D., Klausen, A., Koch, C., Schlauch, W., & Röhrig, R. (2017, September). Alarm Fatigue: Causes and Effects. In GMDS (pp. 107-111).