Fostering advanced evidence-based clinical skills rooted in evidence-based practice and data is a key outcome of the online Registered Nurse (RN) to Bachelor of Science in Nursing (BSN) program from The University of Texas at Arlington (UTA). These skills help professionals not only maximize the efficacy of their nursing practice, but also better address factors that detract from both the nurse’s well-being and patient outcomes. Alarm fatigue, also known as alarm burden, is one such factor.
Alarm fatigue in nursing — the sensory overload and desensitization that clinicians experience when exposed to an excessive number of alarms — is a real and serious problem. A seminal 2013 article from the American Association of Critical-Care Nurses (AACN) highlighted the danger and prevalence of alarm fatigue. A decade later, AACN released a follow-up, noting in the 2023 article abstract: “Alarm fatigue continues to be an issue that researchers, clinicians, and organizations aim to remediate.”
While the issue persists, effective approaches have been developed that continue to reduce alarm fatigue in healthcare settings. According to AACN, evidence-based approaches and alarm management strategies are critical to these efforts in the clinical environment as well as in engineering research and application.
Serious Consequences
Unfortunately, highly sensitive alarms in healthcare settings can lead to sacrificing specificity or accuracy. Overly sensitive or inaccurate alarms may sound constantly, overwhelming nurses and other staff while also desensitizing them. This “crying wolf,” in turn, leads to delayed response and missed alarms.
Alarm fatigue can result in a diverse array of consequences. According to AACN, “Alarm fatigue contributes to missed alarms and medical errors that result in patient death, increased clinical workload and burnout, and interference with patient recovery.”
For instance, if staff is overly desensitized to the sound and fails to respond to a soft alarm signaling that a battery needs replacing, that battery may eventually die. When the alarm fails to work due to having a dead battery, nurses won’t be alerted when a true crisis occurs. In the case of emergencies like cardiac arrest, this could result in a patient death because nurses aren’t alerted and don’t reach the patient in time to resuscitate them.
Alarm Fatigue Research and Contributing Factors in Nursing
In order to eliminate alarm fatigue in nursing and change staff behavior, researchers in any institution must document and define the problem. Resulting analysis can break down alarms that result in burden or fatigue into three categories: false alarms, nuisance alarms and inopportune alarms. Various factors contribute to these alarm fatigue issues.
For instance, alarm parameter thresholds may be set too tight. This can result in false alarms. Alarm settings may also be generic — not adjusted to the individual patient and their condition — making alarm results false, inaccurate or a nuisance as they are not relevant to the patient’s specific condition or needs.
Further, an alarm may signal something at the wrong time, whether too early or too late, making it an inopportune alarm. Staff may be unable to hear alarms or detect where an alarm is coming from. Staff training on monitors and alarms may be inadequate, or they may have too dense a workload, leading to an ineffective response to alarms. Alarms may also simply malfunction.
How to Use Evidence-based Practice to Decrease Alarm Fatigue in Nursing
Alarm fatigue is systemic and needs to be addressed at the institutional level. One of the first steps is having a nursing staff with proper education and training in the use of evidence-based practice and alarm fatigue. Various studies show that educational intervention can help reduce false alarms as well as the total occurrence of alarms. One way for RNs to increase their knowledge of evidence-based practice is through an online RN to BSN program.
Secondly, a nursing staff that wishes to address alarm fatigue can form an interdisciplinary team to collect data about alarm events and examine previous studies to take advantage of their findings. Understanding contributing factors to alarm fatigue within one’s healthcare environment as well as those experienced in similar environments inform the next steps to address the issue.
Once the team has gathered data and completed research on the latest evidence, they can decide on an evidence-based alarm management policy and process. Within the policy, alarm settings and parameters should be customized and adjusted based on the needs of staff and individual patients as well as the environment. In addition, staff must decide where alarms are not needed and assure that equipment is maintained properly.
The number of technological devices with bedside alarms has grown exponentially in the last few decades, and alarm fatigue in nursing is a system-wide challenge that needs to be approached holistically. BSN-prepared nurses with education in the use of evidence-based practices can help create policies to reduce alarm fatigue and improve overall patient care.
Learn more about the UTA online RN to BSN program.
