Assessing Causes of Alarm Fatigue in Long-Term Acute Care and Its Impact on Identifying Clinical Changes in Patient Conditions
Open accessAbstract
Physiologic alarms are an important modality in the care of critically ill patients. Yet the many electronic devices used in patient care and the combination of alarms can cause sensory overload in caregivers. This sensory overload can lead to monitor fatigue, and caregivers may miss critical alarms, which can be fatal for patients. Many factors not related to a change in patients' condition can be directly linked to desensitization and alarm fatigue, leading to a failure to recognize or attend to true instability in spite of the alarm. Research demonstrates that the majority of alarms are non-actionable, and staff can develop alarm fatigue trying to determine which alarms are valid and which are not. We postulate that more experience detecting false alarms among professionals in a long-term acute care unit will lead to improved clinical changes and better survival rates among patients. Our proportional hazards model relates missing clinical changes in patients' condition as time passes, after reduced attention to false alarms, to professional experience. In our proportional hazards model, the unique effect of a unit increase in a covariate is multiplicative with respect to the hazard rate. Therefore, reduced attention to false alarms by experienced professionals decreases the hazard rate for missing a clinical change. We use survival analyses, the hazard function, the receiver-operating characteristic curve, and the Hosmer-Lemeshow test to support our conclusions. Our results show that monitoring equipment is instrumental in alerting staff in a long-term care unit to serious changes in patients’ condition and in preventing false positives and false negatives.
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Alarm fatigue desensitizes clinicians to real alerts, causing delays or missed recognition of critical patient changes and increasing diagnostic errors.
“Additionally, alarm fatigue desensitizes healthcare clinicians to real alerts, causing delays or missed recognition of critical patient changes and increasing diagnostic errors due to the overwhelming presence of false or non-actionable alarms [301].”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [301]
The Abstract and Conclusions (page unavailable) link false or non-actionable alarms to desensitization and failure to recognize or attend to genuine changes in a patient’s condition. The Introduction also describes delayed responses and missed alarms. Our copy does not establish that alarm fatigue increases diagnostic errors, so that part of the attributed claim is unsupported. (LLM, conf=0.88)
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References 26 · Cited by 24
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- Authors
- Baker, K., & Rodger, J.
- Affiliations
- Indiana University of Pennsylvania (US)
- Corresponding author
- Rodger, James
- ORCID
- Rodger, James
- Venue
- Informatics in Medicine Unlocked
- Publisher
- Elsevier BV
- Published
- 2020
- Volume
- 18
- Pages
- 100300
- ISSN
- 2352-9148 (ISSN-L)
- OpenAlex
- W3005343301
- Cited by
- 24
- References
- 26
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 4 · 2023: 5 · 2022: 3 · 2021: 3 · 2020: 1
- FWCI
- 2.75
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Informatics in Medicine Unlocked (publishedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- 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 › Family Practice › Clinical Reasoning and Diagnostic Skills
- Keywords
- alarm fatigue, long-term acute care, false alarms, desensitization, employee experience, patient survival, intensive care monitoring, proportional hazards model
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