| Objective: The current situation of alarm cognition and alarm fatigue of nurses in ICU of four tertiary hospitals of Qinhuangdao City is investigated to know the influencing factors and analyze the factors that hinder effective alarm management,so as to improve the alarm cognition of the nurses in ICU of Qinhuangdao City,alleviating their alarm fatigue,and providing a basis for effective alarm management.Method: This study used a convenient sampling method for the questionnaire survey.There were 220 registered nurses in the intensive care unit that met the inclusion criteria,conducted a questionnaire survey,distributed 220 questionnaires,and collected 215 questionnaires,with a recovery rate of 98%.The investigation was completed on September 10,2019.The questionnaire was edited with Wenjuanxing software.Respondents answered the questionnaire after scanning the QR code,and would to finish certain questions before submitting it to ensure the quality of the questionnaire.The questionnaire consists of general information of the nurses in ICU,clinical alarm cognition and clinical alarm fatigue.The collected datum were analyzed with SPSS 21.0 software system,there was statistical significance(P <0.05).Results: 1 Investigation results of clinical alarms in intensive care units 1.1 Alarm cognitive resultsThe result shows that the three top entries for nurses' clinical alarm cognition are "Alarm sounds and/or visual displays should differentiate the priority of alarm","Alarm sounds and/or visual displays should be distinct based on the parameter(e.g.heart rate)or source(device type)" and "Nuisance alarms disrupt patient care".Among them,the difference in education and position is the main factor affecting the second cognitive item(P <0.05);the difference in the number of night shifts per month is the main factor affecting the cognition of "Nuisance alarms disrupt patient care"(P <0.05).The three bottom entries are "There have been frequent instances where alarms could not be heard and were missed","Clinical policies and procedures regarding alarm management are effectively used in my facility" and "Newer monitoring systems(e.g.<3 years old)have solved most of the previous problems we experienced with clinical alarms".Among them,the difference in job title and working life is the main factor that affects "There have been frequent instances where alarms could not be heard and were missed"(P <0.05);the habit of absence of setting medical equipment alarm is the main factor affecting the recognition of the last item(P < 0.05).1.2 Current status of alarm safety management in departmentsNo one is aware of adverse effect related to clinical alarms that the hospital had experienced in the past 2 years.The central monitoring area did not play a significant role in helping bedside nurses.In the past two years,the department had formulated alarm-related measures and developed new solutions.1.3 The obstacles to effective alarm managementIn terms of the degree of difficulty,the first item is "Frequent false alarms,reducing attention or response to alarms that occur" and the last is "Lack of training on alarm systems".2 Fatigue status of nurses in intensive care units 2.1 The total score of the nurse's alarm fatigue was(24.63 ± 8.99)points,which was a severe alarm fatigue state.The item with the highest score was "I feel out of my mind due to clinical alarms" with a score of(3.60 ± 1.41)."I am bothered in everything by clinical alarms" got the lowest score(3.44 ± 1.36).2.2 A single factor analysis of the alert fatigue level of the intensive care unit nurses showed that the main influencing fators were marital status,highest academic qualifications,titles,job titles,years of work,number of night shifts per month,and the habit of setting medical device alarms and alert fatigue levels There was statistical significance(P <0.05).Multiple linear regression analysis of alarm fatigue of ICU nurses showed that the main influencing factors were marital status,job position,working years,job title and education.Among them,marital status has the greatest influence,followed by position.Besides those who were unmarried,higher professional title,long working years,higher rank and higher education were negatively correlated with alarm fatigue(P<0.05),while those who have no alarm-setting habit were positive correlation with alarm fatigue(P<0.05).Conclusions:1.Nurses with different characteristics have different perceptions of alarms.Among them,junior college graduates and non-positional nurses can recognize the importance of alarm sounds and visual cues.Nurses with ?11 days of monthly shifts perceive nuisance alarms and interrupt nursing work.However,awareness training on missed alarms,false alarm and alarm management policies,and new monitoring systems for young nurses should be strengthened.2.Strengthen the management of clinical medical equipment alarm-related adverse events and central station management.3.ICU nurses in severe alarm fatigue,among them,nurses who are married,lower education,lower rank,lower professional title,less working years,and without alarm-setting habit have heavy alarm fatigue.The management and training of nurses with these characteristics should be strengthened to improve their professional level and provide protection for the safety of patients To improve the quality of nursing services. |
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