2.50
Hdl Handle:
http://hdl.handle.net/10755/623947
Category:
Full-text
Format:
Text-based Document
Type:
Research Study
Level of Evidence:
Cross-Sectional Study
Research Approach:
Mixed/Multi Method Research
Title:
Challenges of Customizing ECG Alarm Settings in Intensive Care Units: A Mixed Methods Study
Author(s):
Ruppel, Halley; Funk, Marjorie; Kennedy, Holly; Bonafide, Christopher; Wung, Shu-Fen; Whittemore, Robin
Lead Author STTI Affiliation:
Delta Mu
Author Details:
Halley Ruppel, MS, RN, email: halley.ruppel@yale.edu; Marjorie Funk, PhD, RN, FAHA, FAAN, email: marjorie.funk@yale.edu; Holly Kennedy, PhD, CNM, FACNM, FAAN, email: holly.kennedy@yale.edu; Christopher Bonafide, MD, email: BONAFIDE@email.chop.edu; Shu-Fen Wung, PhD, MS, RN, ACNP-BC, FAAN, email: wung@email.arizona.edu; Robin Whittemore, PhD, APRN, FAAN, email: robin.whittemore@yale.edu
Abstract:

Background: Alarm fatigue is a well-established patient safety concern in acute care settings. One mechanism for reducing this phenomenon and improving patient care is customization of alarm settings to reflect individual patient conditions.

Purpose: The purpose of this study was to generate an understanding of intensive care unit (ICU) nurses’ approach to customization of electrocardiography (ECG) alarms on the physiologic monitor, by describing their customization practices and exploring their clinical reasoning and judgment toward customization.

Methods: A convergent parallel mixed methods design was used. Three ICUs were included in the study. Quantitative data on types and frequency of alarms customized were collected from physiologic monitors and qualitative data on nurses’ customization practices were explored through interviews. 

Results: Of the 298 monitors included in the study, 58.7% (n=175) had one or more alarm(s) customized. High and low heart rate limits, irregular heart rate, and atrial fibrillation were the most commonly customized alarm types. Qualitative findings demonstrated that customization practices varied widely among individual nurses, and many factors influenced their clinical reasoning, including level of clinical expertise, lack of structured customization education, and past negative experiences.

Conclusions: Practices, decisions, and comfort in customizing alarms varied and reflected individual characteristics of the nurses. 

Keywords:
Intensive Care; Critical Care Nurses; ECG; Alarm Fatigue; Alarm Management
CINAHL Headings:
Equipment Alarm Systems; Intensive Care Units; Critical Care Nursing; Monitoring, Physiologic; Electrocardiography; Patient Safety
Repository Posting Date:
22-Mar-2018
Date of Publication:
22-Mar-2018
Sponsors:
Sigma Theta Tau International; Connecticut Nurses Foundation
Description:
Sigma Theta Tau International Doris Bloch award; Connecticut Nurses Foundation; Halley Ruppel is a Robert Wood Johnson Foundation Future of Nursing Scholar
Note:
The Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typeResearch Studyen
dc.evidence.levelCross-Sectional Studyen
dc.research.approachMixed/Multi Method Researchen
dc.titleChallenges of Customizing ECG Alarm Settings in Intensive Care Units: A Mixed Methods Studyen_US
dc.contributor.authorRuppel, Halleyen
dc.contributor.authorFunk, Marjorieen
dc.contributor.authorKennedy, Hollyen
dc.contributor.authorBonafide, Christopheren
dc.contributor.authorWung, Shu-Fenen
dc.contributor.authorWhittemore, Robinen
dc.contributor.departmentDelta Muen
dc.author.detailsHalley Ruppel, MS, RN, email: halley.ruppel@yale.edu; Marjorie Funk, PhD, RN, FAHA, FAAN, email: marjorie.funk@yale.edu; Holly Kennedy, PhD, CNM, FACNM, FAAN, email: holly.kennedy@yale.edu; Christopher Bonafide, MD, email: BONAFIDE@email.chop.edu; Shu-Fen Wung, PhD, MS, RN, ACNP-BC, FAAN, email: wung@email.arizona.edu; Robin Whittemore, PhD, APRN, FAAN, email: robin.whittemore@yale.eduen
dc.identifier.urihttp://hdl.handle.net/10755/623947-
dc.description.abstract<p><strong>Background: </strong>Alarm fatigue is a well-established patient safety concern in acute care settings. One mechanism for reducing this phenomenon and improving patient care is customization of alarm settings to reflect individual patient conditions.</p> <p><strong>Purpose: </strong>The purpose of this study was to generate an understanding of intensive care unit (ICU) nurses’ approach to customization of electrocardiography (ECG) alarms on the physiologic monitor, by describing their customization practices and exploring their clinical reasoning and judgment toward customization.<strong></strong></p> <p><strong>Methods: </strong>A convergent parallel mixed methods design was used. Three ICUs were included in the study. Quantitative data on types and frequency of alarms customized were collected from physiologic monitors and qualitative data on nurses’ customization practices were explored through interviews. </p> <p><strong>Results:</strong> Of the 298 monitors included in the study, 58.7% (n=175) had one or more alarm(s) customized. High and low heart rate limits, irregular heart rate, and atrial fibrillation were the most commonly customized alarm types. Qualitative findings demonstrated that customization practices varied widely among individual nurses, and many factors influenced their clinical reasoning, including level of clinical expertise, lack of structured customization education, and past negative experiences.</p> <p><strong>Conclusions: </strong>Practices, decisions, and comfort in customizing alarms varied and reflected individual characteristics of the nurses. </p>en
dc.subjectIntensive Careen
dc.subjectCritical Care Nursesen
dc.subjectECGen
dc.subjectAlarm Fatigueen
dc.subjectAlarm Managementen
dc.subject.cinahlEquipment Alarm Systemsen
dc.subject.cinahlIntensive Care Unitsen
dc.subject.cinahlCritical Care Nursingen
dc.subject.cinahlMonitoring, Physiologicen
dc.subject.cinahlElectrocardiographyen
dc.subject.cinahlPatient Safetyen
dc.date.available2018-03-22T21:14:35Z-
dc.date.issued2018-03-22-
dc.date.accessioned2018-03-22T21:14:35Z-
dc.description.sponsorshipSigma Theta Tau Internationalen
dc.description.sponsorshipConnecticut Nurses Foundationen
dc.descriptionSigma Theta Tau International Doris Bloch award; Connecticut Nurses Foundation; Halley Ruppel is a Robert Wood Johnson Foundation Future of Nursing Scholaren
dc.description.noteThe Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.-
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