Table 1: Simulation Observations.

Simulation observational data and reflections from the debriefing interview were recorded in a RedCap survey immediately following the simulation.

Session Information

Date simulation performed Unit simulation was performed Start and end time of RN’s shift Number of total patients assigned to RN at time of simulation MRN and bed location of RN’s assignment Acuity index of RN’s overall assignment Acuity index of Individual patients captured in the EHR Total alarms and level of those alarms received in the hour leading up to the simulation alarm

Time Point Metrics

Time of low SpO2 alarm on the monitor Time of notification on the ASCOM phone Time of RN or responding staff member to bedside or t=10 min

Observer Gathered Data

Is the CIC making noise during the simulation? Did you notice anyone interact with the CIC during the simulation alarm? How did they interact with the CIC monitors? Was any family at the bedside? Where is RN carrying the ASCOM? (chest, hip, etc)? What caused the end of the simulation? Is the bedside nurse the responder to the alarm?

Debriefing interview with the bedside RN

What other tasks were you engaged in when the monitor’s alarm went off on your ASCOM? Or how would you describe your activities within the last 10 minutes? What did you think when you first got the alarm? Did you think this was a credible alarm? Why or why not? How did you prioritize the alarm vs your other tasks? What are your thoughts about the tone of the alarm, do you recall what the message said? What audible and vibrate settings was your phone set at?