Algorithm 1 Context-Aware Alert Decision Framework

1:Input: Set of alarms $\mathcal{A}=\{a_1,a_2,\dots ,a_N\}$, where $a_i=(t_i,x_i,u_i,c_i,r_i)$   2:Initialize: Effective alert set ${\mathcal{A}}^{*}\leftarrow Ø$   3:for all  $a_i\in \mathcal{A}$  do   4:    // Suppression Check   5:    if $x_i>{\theta }_x$ or $u_i<{\theta }_u$ or $care\left(c_i\right)\in \left\{\mathrm{low}\text{-}\mathrm{priority}\right\}$ then   6:        Discard $a_i$ and log suppression   7:        continue   8:    end if   9:    // Context-Aware Delay Assignment 10:    Compute delay: $D\left(a_i\right)={\alpha }_1(1-u_i)+{\alpha }_2{r}_i+{\alpha }_3{c}_i$ 11:    if $t_i+D\left(a_i\right)>T_{\mathrm{ack}}\mathbf{then}$ 12:        Discard $a_i$ due to unacceptable delay 13:        continue 14:    end if 15:    // LLM-Based Validation and Nurse Assignment 16:    Generate prompt: $\mathrm{Prompt}\left(a_i\right)=T(t_i,x_i,u_i,c_i,r_i)$ 17:    Query LLM to get: $\mathrm{priority}\left(a_i\right)$ and assigned nurse $n^{*}$ 18:    Compute dynamic threshold $\tau (c_i,x_i,r_i,t_i)$ 19:    if $\mathrm{priority}\left(a_i\right)<\tau (c_i,x_i,r_i,t_i)$ then 20:        Discard $a_i$ (Not clinically significant) 21:        continue 22:    end if 23:    // Notification Dispatch 24:    Send alert $a_i$ to nurse $n^{*}$ 25:    Start acknowledgment timer $T_{\mathrm{ack}}$ 26:    if No acknowledgment within $T_{\mathrm{ack}}$ then 27:        Escalate to next-best nurse $n^{\prime }$ 28:    end if 29:    Update workload and availability for assigned nurse 30:    Add $a_i$ to effective alert set: ${\mathcal{A}}^{*}\leftarrow {\mathcal{A}}^{*}\cup \left\{a_i\right\}$ 31:end for 32:Output: Escalated and handled alert set ${\mathcal{A}}^{*}$