The effect of a clinical approach to ventilator alarm management on alarm fatigue in intensive care nurses: a randomized controlled trial
Abstract Background Every day in intensive care units (ICUs), many alarms from several devices -especially ventilators- are generated, creating a noisy environment, which is on the top of technology-related hazards and may lead to alarm fatigue among nurses. This study aimed to investigate the impac...
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BMC
2025-07-01
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| Series: | BMC Nursing |
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| Online Access: | https://doi.org/10.1186/s12912-025-03500-3 |
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| author | Amirhossein Nasirmoghadas Atefe Salimi Akinabadi Yekta Rahimi Neda Sanaie Ladan Sedighi |
| author_facet | Amirhossein Nasirmoghadas Atefe Salimi Akinabadi Yekta Rahimi Neda Sanaie Ladan Sedighi |
| author_sort | Amirhossein Nasirmoghadas |
| collection | DOAJ |
| description | Abstract Background Every day in intensive care units (ICUs), many alarms from several devices -especially ventilators- are generated, creating a noisy environment, which is on the top of technology-related hazards and may lead to alarm fatigue among nurses. This study aimed to investigate the impact of a clinical approach to ventilator alarm management on nurses’ alarm fatigue and alarm frequency in ICUs. Methods This randomized controlled trial involved 75 nurses in two general ICUs allocated into control and intervention groups using cluster randomization. In the intervention group (IG), clinical causes and solutions of common ventilator alarms were trained in a 4-hour online webinar. Then, an evidence-based guideline for alarm management was attached to all ventilators in the intervention ICU. Additionally, nurses of the IG were trained virtually and face-to-face regarding the fundamentals of mechanical ventilation and how to manage ventilator alarms for one month. Before and after the intervention, nurses’ alarm fatigue and frequency of three common alarms were recorded for five consecutive days. The control group (CG) did not receive the educational content. Data were analyzed using SPSS-26. This study adheres to CONSORT guidelines. Results The baseline characteristics were not significantly different between the groups. Also, alarm fatigue scores of nurses did not significantly differ between groups before the intervention (p = 0.17). In the IG, nurses’ alarm fatigue scores significantly decreased from 24.86 ± 6.65 to 20.24 ± 4.39 (p < 0.025) and its difference was significant between the groups (p < 0.001). However, alarm fatigue scores in the CG did not improve significantly after one month. As a secondary outcome, the frequency of three common alarms including high pressure (–34.3%), high minute volume/tidal volume (–28.6%), and high respiratory rate (–25.4%) was reduced after the intervention. Conclusion This study indicated that training and implementing an evidence-based clinical approach to ventilator alarm management not only reduced nurses’ alarm fatigue but also could lead to a significant reduction in the common ventilator alarms frequency. Trial registration This study was prospectively registered by the Iranian Registry of Clinical Trials ( https://irct.behdasht.gov.ir/ ) on 01/09/2024 with registration ID: IRCT20240306061197N2. |
| format | Article |
| id | doaj-art-3033c1066c904efdabfe3da648e8ab9c |
| institution | DOAJ |
| issn | 1472-6955 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Nursing |
| spelling | doaj-art-3033c1066c904efdabfe3da648e8ab9c2025-08-20T03:03:27ZengBMCBMC Nursing1472-69552025-07-0124111010.1186/s12912-025-03500-3The effect of a clinical approach to ventilator alarm management on alarm fatigue in intensive care nurses: a randomized controlled trialAmirhossein Nasirmoghadas0Atefe Salimi Akinabadi1Yekta Rahimi2Neda Sanaie3Ladan Sedighi4Clinical Research Development Center, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical SciencesClinical Research Development Center, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical SciencesStudent Research Committee, School of Public Health and Safety, Shahid Beheshti University of Medical SciencesDepartment of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical SciencesDepartment of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical SciencesAbstract Background Every day in intensive care units (ICUs), many alarms from several devices -especially ventilators- are generated, creating a noisy environment, which is on the top of technology-related hazards and may lead to alarm fatigue among nurses. This study aimed to investigate the impact of a clinical approach to ventilator alarm management on nurses’ alarm fatigue and alarm frequency in ICUs. Methods This randomized controlled trial involved 75 nurses in two general ICUs allocated into control and intervention groups using cluster randomization. In the intervention group (IG), clinical causes and solutions of common ventilator alarms were trained in a 4-hour online webinar. Then, an evidence-based guideline for alarm management was attached to all ventilators in the intervention ICU. Additionally, nurses of the IG were trained virtually and face-to-face regarding the fundamentals of mechanical ventilation and how to manage ventilator alarms for one month. Before and after the intervention, nurses’ alarm fatigue and frequency of three common alarms were recorded for five consecutive days. The control group (CG) did not receive the educational content. Data were analyzed using SPSS-26. This study adheres to CONSORT guidelines. Results The baseline characteristics were not significantly different between the groups. Also, alarm fatigue scores of nurses did not significantly differ between groups before the intervention (p = 0.17). In the IG, nurses’ alarm fatigue scores significantly decreased from 24.86 ± 6.65 to 20.24 ± 4.39 (p < 0.025) and its difference was significant between the groups (p < 0.001). However, alarm fatigue scores in the CG did not improve significantly after one month. As a secondary outcome, the frequency of three common alarms including high pressure (–34.3%), high minute volume/tidal volume (–28.6%), and high respiratory rate (–25.4%) was reduced after the intervention. Conclusion This study indicated that training and implementing an evidence-based clinical approach to ventilator alarm management not only reduced nurses’ alarm fatigue but also could lead to a significant reduction in the common ventilator alarms frequency. Trial registration This study was prospectively registered by the Iranian Registry of Clinical Trials ( https://irct.behdasht.gov.ir/ ) on 01/09/2024 with registration ID: IRCT20240306061197N2.https://doi.org/10.1186/s12912-025-03500-3Alarm fatigueEvidence-based practiceAlarm managementMechanical ventilationIntensive care units |
| spellingShingle | Amirhossein Nasirmoghadas Atefe Salimi Akinabadi Yekta Rahimi Neda Sanaie Ladan Sedighi The effect of a clinical approach to ventilator alarm management on alarm fatigue in intensive care nurses: a randomized controlled trial BMC Nursing Alarm fatigue Evidence-based practice Alarm management Mechanical ventilation Intensive care units |
| title | The effect of a clinical approach to ventilator alarm management on alarm fatigue in intensive care nurses: a randomized controlled trial |
| title_full | The effect of a clinical approach to ventilator alarm management on alarm fatigue in intensive care nurses: a randomized controlled trial |
| title_fullStr | The effect of a clinical approach to ventilator alarm management on alarm fatigue in intensive care nurses: a randomized controlled trial |
| title_full_unstemmed | The effect of a clinical approach to ventilator alarm management on alarm fatigue in intensive care nurses: a randomized controlled trial |
| title_short | The effect of a clinical approach to ventilator alarm management on alarm fatigue in intensive care nurses: a randomized controlled trial |
| title_sort | effect of a clinical approach to ventilator alarm management on alarm fatigue in intensive care nurses a randomized controlled trial |
| topic | Alarm fatigue Evidence-based practice Alarm management Mechanical ventilation Intensive care units |
| url | https://doi.org/10.1186/s12912-025-03500-3 |
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