Systematic Review of Physiologic Monitor Alarm Characteristics and Pragmatic Interventions to Reduce Alarm Frequency
Open accessAbstract
BACKGROUND: Alarm fatigue from frequent nonactionable physiologic monitor alarms is frequently named as a threat to patient safety. PURPOSE: To critically examine the available literature relevant to alarm fatigue. DATA SOURCES: Articles published in English, Spanish, or French between January 1980 and April 2015 indexed in PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Cochrane Library, Google Scholar, and ClinicalTrials.gov. STUDY SELECTION: Articles focused on hospital physiologic monitor alarms addressing any of the following: (1) the proportion of alarms that are actionable, (2) the relationship between alarm exposure and nurse response time, and (3) the effectiveness of interventions in reducing alarm frequency. DATA EXTRACTION: We extracted data on setting, collection methods, proportion of alarms determined to be actionable, nurse response time, and associations between interventions and alarm rates. DATA SYNTHESIS: Our search produced 24 observational studies focused on alarm characteristics and response time and 8 studies evaluating interventions. Actionable alarm proportion ranged from <1% to 36% across a range of hospital settings. Two studies showed relationships between high alarm exposure and longer nurse response time. Most intervention studies included multiple components implemented simultaneously. Although studies varied widely, and many had high risk of bias, promising but still unproven interventions include widening alarm parameters, instituting alarm delays, and using disposable electrocardiographic wires or frequently changed electrocardiographic electrodes. CONCLUSIONS: Physiologic monitor alarms are commonly nonactionable, and evidence supporting the concept of alarm fatigue is emerging. Several interventions have the potential to reduce alarms safely, but more rigorously designed studies with attention to possible unintended consequences are needed. Journal of Hospital Medicine 2016;11:136–144. © 2015 Society of Hospital Medicine
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Up to 99% of all auditory alarms are false alarms that do not change patient treatment.
“Of all auditory alarms, up to 99% have been described to be false alarms that do not change patient treatment [28].”
From Clinical requirements of future patient monitoring in the intensive care unit: qualitative study (2019) · cites this paper as [28]
Several strategies have been developed to reduce false alarms in the ICU, but implementation into clinical routine is still lacking.
“Although several strategies have been developed to reduce false alarms in the ICU [12,28-31], implementation into a clinical routine is still lacking.”
From Clinical requirements of future patient monitoring in the intensive care unit: qualitative study (2019) · cites this paper as [28]
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- Authors
- Paine, C. W., Goel, V. V., Ely, E., Stave, C. D., Stemler, S., Zander, M., & Bonafide, C. P.
- Affiliations
- Children's Hospital of Philadelphia (US)
- Lucile Packard Children's Hospital (US)
- Stanford Medicine (US)
- ORCID
- Venue
- Journal of Hospital Medicine
- Publisher
- Wiley
- Published
- 2015-12-14
- Volume
- 11
- Issue
- 2
- Pages
- 136-144
- ISSN
- 1553-5592 (ISSN-L)
- 1553-5606
- PMC
- PMC4778561
- OpenAlex
- W2190577106
- Cited by
- 183
- References
- 45
- Citations by year
- 2026: 15 · 2025: 9 · 2024: 15 · 2023: 23 · 2022: 9 · 2021: 20 · 2020: 15 · 2019: 21 · 2018: 28 · 2017: 19 · 2016: 8 · 2015: 1
- FWCI
- 3.57
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Hospital Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Society of Hospital Medicine Student Hospitalist Scholar Grant
- National Heart, Lung, and Blood Institute of the National Institutes of Health (K23HL116427)
- Topics
- Health Sciences › Medicine › Surgery › Healthcare Technology and Patient Monitoring
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- alarm fatigue, nurse response time, patient safety, hospital monitoring systems
- MeSH terms
- Electrocardiography, Hospitals, Humans, Monitoring, Physiologic, Nursing Staff, Hospital, Time Factors, Clinical Alarms, Patient Safety
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