Table 3.
Number and percentage of nurses who agreed or strongly agreed on the statements between the preproject and postproject periods (n=24).
| Item | Statementa | Preproject, n (%) |
Postproject, n (%) |
% changeb |
| 1 | Nuisance alarms occur frequently | 24 (100) | 18 (75) | -25.0 |
| 2 | Nuisance alarms disrupt patient care | 23 (96) | 23 (96) | 0 |
| 3 | Nuisance alarms reduce trust in alarms and cause caregivers to inappropriately turn alarms off at times other than setup or procedural events | 21 (88) | 22 (92) | 4.8 |
| 4 | When a number of devices are used with a patient, it can be confusing to determine which device is in an alarm condition | 21 (88) | 19 (79) | -9.5 |
| 5 | Smart alarms (eg, where multiple parameters, rate of change of parameters, and signal quality are automatically assessed in their entirety) would be effective to use for improving clinical response to important patient alarms | 20 (83) | 17 (71) | -15.0 |
| 6 | Central alarm management staff responsible for receiving alarm messages and alerting appropriate staff is helpful | 19 (79) | 18 (75) | -5.3 |
| 7 | Smart alarms (eg, where multiple parameters, rate of change of parameters, and signal quality are automatically assessed in their entirety) would be effective to use for reducing false alarms | 19 (79) | 16 (67) | -15.8 |
| 8c | Unit layout does interfere with alarm recognition and management | 18 (75) | 18 (75) | 0 |
| 9 | Alarm integration and communication systems via pagers, cell phones, and other wireless devices are useful for improving alarms management and response | 15 (63) | 17 (71) | 13.3 |
| 10c | Nearly all alarms are actionable (requiring the nurse to respond and take an action) | 14 (58) | 14 (58) | 0 |
| 11 | Alarm sounds and/or visual displays of the current monitoring systems and devices should clearly differentiate the priority of alarm | 13 (54) | 14 (58) | 7.7 |
| 12 | Properly setting alarm parameters and alerts is overly complex in existing devices | 13 (54) | 13 (54) | 0 |
| 13 | Clinical staff is sensitive to alarms and responds quickly | 13 (54) | 15 (63) | 15.4 |
| 14c | When a lethal alarm sounds, it is clearly and quickly recognized and immediate action is taken to address the alarm | 12 (50) | 14 (58) | 16.7 |
| 15 | Environmental background noise has interfered with alarm recognition | 12 (50) | 15 (63) | 25.0 |
| 16 | Alarm sounds and/or visual displays should be distinct based on the parameter or source (eg, device) | 12 (50) | 16 (67) | 33.3 |
| 17d | There is a requirement in my unit to document that the alarms are set and are appropriate for each patient | 11 (46) | 18 (75) | 63.6 |
| 18d | The alarms used on my unit are adequate to alert staff of potential or actual changes in a patient’s condition | 10 (42) | 9 (38) | -10.0 |
| 19 | There have been frequent instances where alarms could not be heard and were missed | 8 (33) | 8 (33) | 0 |
| 20d | The medical devices used on my unit all have distinct outputs (ie, sounds, repetition rates, visual displays) that allow users to identify the source of the alarm | 8 (33) | 15 (63) | 87.5 |
| 21d | Clinical policies and procedures regarding alarm management are effectively used in my unit | 6 (25) | 11 (46) | 83.3 |
| 22 | Newer monitoring systems (eg, < 3 years old) have solved most of the previous problems we experienced with clinical alarms | 1 (4) | 6 (25) | 500 |
aEdited and used with permission from the Healthcare Technology Foundation (HTF) 2011.
bPercent change = ((y2 - y1) / y1) × 100.
cThese are the new statements that we added to our survey. They do not exist in the original HTF survey.
dThese are the statements where the “floor/area of the hospital” or “institution” in the HTF clinical alarms survey were replaced with “unit” in our survey.