Alarms in the ICU: A study investigating how ICU nurses respond to clinical alarms for patient safety in a selected hospital in KwaZulu-Natal Province, South Africa

Abstract

Background Advances in technology have facilitated the implementation of improved alarm management systems in the healthcare sector. There is a need to identify challenges encountered by intensive care unit (ICU) nurses with clinical alarm management systems in South Africa (SA) to ensure utilisation of these technological resources for patient safety. Objectives To investigate how intensive care nurses respond to clinical alarms for patient safety in a selected hospital in KwaZulu-Natal Province, SA. Methods A descriptive, non-experimental research design using the census sampling strategy was used to invite 120 nurses from four ICUs to complete an adapted, structured questionnaire. Descriptive statistics were used to analyse the data. Results We had 91 respondents who completed the questionnaires (response rate of 75.8%). The majority of the respondents (85.7%) strongly knew the purpose of clinical alarms and 45.1% strongly felt confident about adjusting and monitoring the clinical alarms. More than half of the nurses (53.8 %) agreed to the existence of nuisance alarms that disrupted patient care (46.7%) and contributed to lack of responses (52.7%). While 76.9% strongly agreed with alarm sounds and displays to differentiate the priority of the alarms, 75.8% strongly agreed to the existence of proper documentation on setting alarms that are appropriate for each patient. The most frequent barriers were difficulty in setting alarms properly (51.6%) and lack of training on alarm systems (47.8%). Conclusion The complexity in setting the alarms, limited training and existence of false alarms was evident. Alarm-specific training is required to keep intensive care nurses updated with changes in technology to ensure patient safety. Contributions of the study The findings of this present study highlighted the importance of understanding the alarm management system within the ICU environment of the healthcare sector in SA. Technological improvements, specialised trainings and clear clinical policies for alarm management are essential to improve patient safety.