Multicentric study of monitoring alarms in the adult intensive care unit (ICU): a descriptive analysis
Abstract
Objectives To assess the relevance of current monitoring alarms as a warning system in the adult ICU.Design Prospective, observational study.Settings Two university hospital, and three general hospital, ICUs.Patients Hundred thirty-one patients, ventilated at admission, from different shifts (morning, evening, night) combined with different stages of stay, early (0-3 days), intermediate (4-6 days) and late (> 6 days).Interventions Experienced nurses were asked to record the patient's characteristics and, for each alarm event, the reason, type and consequence.Measurements and main results The mean age of the patients included was 59.8 +/- 16.4 and SAPS1 was 15.9 +/- 7.4. We recorded 1971 h of care. The shift distribution was 78 mornings, 85 evenings and 83 nights; the stage distribution was 88 early, 78 intermediate and 80 late. There were 3188 alarms, an average of one alarm every 37 min: 23.7% were due to staff manipulation, 17.5% to technical problems and 58.8% to the patients. Alarms originated from ventilators (37.8%), cardiovascular monitors (32.7%), pulse oximeters (14.9%) and capnography (13.5%). Of the alarms, 25.8% had a consequence such as sensor repositioning, suction, modification of the therapy (drug or ventilation). Only 5.9% of the alarms led to a physician's being called. The positive predictive value of an alarm was 27% and its negative predictive value was 99%. The sensitivity was 97% and the specificity 58%.Conclusions The study confirms that the level of monitoring in ICUs generates a great number of false-positive alarms.
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- Authors
- Chambrin, M.-C., Ravaux, P., Calvelo-Aros, D., Jaborska, A., Chopin, C., & Boniface, B.
- Affiliations
- Inserm (FR)
- Université de Lille (FR)
- ORCID
- Ravaux, P.
- Venue
- Intensive Care Medicine
- Published
- 1999-12
- Volume
- 25
- Issue
- 12
- Pages
- 1360-1366
- ISSN
- 0342-4642 (ISSN-L)
- 1432-1238
- OpenAlex
- W1997522188
- Cited by
- 227
- References
- 10
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 7 · 2023: 6 · 2022: 4 · 2021: 6 · 2020: 9 · 2019: 6 · 2018: 14 · 2017: 11 · 2016: 13 · 2015: 22 · 2014: 19 · 2013: 21 · 2012: 15
- FWCI
- 3.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Intensive Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Healthcare Technology and Patient Monitoring
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- alarm fatigue, false positive alerts, intensive care unit, mechanical ventilation, patient monitoring, alarm response, positive predictive value, pulse oximetry, capnography
- MeSH terms
- Adult, Electrocardiography, Equipment Failure, False Positive Reactions, Female, France, Hospitals, General, Hospitals, University, Humans, Intensive Care Units, Length of Stay, Male, Middle Aged, Monitoring, Physiologic, Oximetry, Predictive Value of Tests, Prospective Studies, Respiration, Artificial, Sensitivity and Specificity, Severity of Illness Index, Safety Management, Capnography
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