Alarm fatigue in healthcare: a scoping review of definitions, influencing factors, and mitigation strategies

Abstract Background Alarm Fatigue is recognized as a significant risk to both patient safety and the well-being of healthcare professionals (HCPs). However, it remains an underexplored phenomenon, further complicated by the lack of a harmonized definition. This review aims to (1) propose a harmonize...

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Main Authors: Elizabeth Anna Mathilde Michels, Stephen Gilbert, Iulia Koval, Magdalena Katharina Wekenborg
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Nursing
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Online Access:https://doi.org/10.1186/s12912-025-03369-2
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author Elizabeth Anna Mathilde Michels
Stephen Gilbert
Iulia Koval
Magdalena Katharina Wekenborg
author_facet Elizabeth Anna Mathilde Michels
Stephen Gilbert
Iulia Koval
Magdalena Katharina Wekenborg
author_sort Elizabeth Anna Mathilde Michels
collection DOAJ
description Abstract Background Alarm Fatigue is recognized as a significant risk to both patient safety and the well-being of healthcare professionals (HCPs). However, it remains an underexplored phenomenon, further complicated by the lack of a harmonized definition. This review aims to (1) propose a harmonized definition; (2) identify operationalization methods; (3) summarize influencing factors; (4) examine consequences; and (5) outline potential strategies for reducing Alarm Fatigue. Methods This scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A systematic search was conducted in PubMed, CINAHL, MEDLINE, and Google Scholar using keywords related to Alarm Fatigue, covering the literature published up to April 2024. Publications were included if they addressed at least one of the five review objectives. Extracted data covered definitions, operationalization methods, influencing factors, consequences, and mitigation strategies. Results A total of 32 publications were included. Definitions varied, but most described Alarm Fatigue as a phenomenon in which repeated exposure to frequent or non-actionable alarms leads to sensory overload, emotional strain, and a gradual desensitization or reduced responsiveness among HCPs, increasing the risk of delayed or inadequate alarm responses and compromising patient safety. Self-report questionnaires and observational methods were most frequently used tools for operationalization, while physiological and lab-based approaches were rare. Alarm overload, psychosocial work conditions, and individual traits have been identified as factors that may increase the likelihood of Alarm Fatigue. In turn, Alarm Fatigue was linked to delayed alarm responses, communication breakdowns, and increased stress and burnout among HCPs. Identified strategies for reducing Alarm Fatigue included training programs, technical improvements (e.g., alarm customization), protocol adjustments, and broader organizational interventions. Conclusions The review highlights Alarm Fatigue as a complex and clinically relevant issue. By proposing a harmonized definition and mapping key findings across five domains, it offers a structured foundation for future research. Standardized definitions and measurement tools, along with targeted multi-level interventions, are essential for addressing Alarm Fatigue and improving both patient safety and working conditions in healthcare. Trial registration The review was preregistered on the website https://aspredicted.org with the preregistration number #169,578. Clinical trial number Not applicable.
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spelling doaj-art-9d9977abb1b440feafaa78b9f87da9532025-08-20T02:10:31ZengBMCBMC Nursing1472-69552025-06-0124111310.1186/s12912-025-03369-2Alarm fatigue in healthcare: a scoping review of definitions, influencing factors, and mitigation strategiesElizabeth Anna Mathilde Michels0Stephen Gilbert1Iulia Koval2Magdalena Katharina Wekenborg3Else Kröner Fresenius Center for Digital Health, Faculty of Medicine, Technical University DresdenElse Kröner Fresenius Center for Digital Health, Faculty of Medicine, Technical University DresdenFaculty of Psychology, Technical University DresdenElse Kröner Fresenius Center for Digital Health, Faculty of Medicine, Technical University DresdenAbstract Background Alarm Fatigue is recognized as a significant risk to both patient safety and the well-being of healthcare professionals (HCPs). However, it remains an underexplored phenomenon, further complicated by the lack of a harmonized definition. This review aims to (1) propose a harmonized definition; (2) identify operationalization methods; (3) summarize influencing factors; (4) examine consequences; and (5) outline potential strategies for reducing Alarm Fatigue. Methods This scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A systematic search was conducted in PubMed, CINAHL, MEDLINE, and Google Scholar using keywords related to Alarm Fatigue, covering the literature published up to April 2024. Publications were included if they addressed at least one of the five review objectives. Extracted data covered definitions, operationalization methods, influencing factors, consequences, and mitigation strategies. Results A total of 32 publications were included. Definitions varied, but most described Alarm Fatigue as a phenomenon in which repeated exposure to frequent or non-actionable alarms leads to sensory overload, emotional strain, and a gradual desensitization or reduced responsiveness among HCPs, increasing the risk of delayed or inadequate alarm responses and compromising patient safety. Self-report questionnaires and observational methods were most frequently used tools for operationalization, while physiological and lab-based approaches were rare. Alarm overload, psychosocial work conditions, and individual traits have been identified as factors that may increase the likelihood of Alarm Fatigue. In turn, Alarm Fatigue was linked to delayed alarm responses, communication breakdowns, and increased stress and burnout among HCPs. Identified strategies for reducing Alarm Fatigue included training programs, technical improvements (e.g., alarm customization), protocol adjustments, and broader organizational interventions. Conclusions The review highlights Alarm Fatigue as a complex and clinically relevant issue. By proposing a harmonized definition and mapping key findings across five domains, it offers a structured foundation for future research. Standardized definitions and measurement tools, along with targeted multi-level interventions, are essential for addressing Alarm Fatigue and improving both patient safety and working conditions in healthcare. Trial registration The review was preregistered on the website https://aspredicted.org with the preregistration number #169,578. Clinical trial number Not applicable.https://doi.org/10.1186/s12912-025-03369-2Alarm fatiguePatient safetyNursesHealthcare quality improvementWell-being at work
spellingShingle Elizabeth Anna Mathilde Michels
Stephen Gilbert
Iulia Koval
Magdalena Katharina Wekenborg
Alarm fatigue in healthcare: a scoping review of definitions, influencing factors, and mitigation strategies
BMC Nursing
Alarm fatigue
Patient safety
Nurses
Healthcare quality improvement
Well-being at work
title Alarm fatigue in healthcare: a scoping review of definitions, influencing factors, and mitigation strategies
title_full Alarm fatigue in healthcare: a scoping review of definitions, influencing factors, and mitigation strategies
title_fullStr Alarm fatigue in healthcare: a scoping review of definitions, influencing factors, and mitigation strategies
title_full_unstemmed Alarm fatigue in healthcare: a scoping review of definitions, influencing factors, and mitigation strategies
title_short Alarm fatigue in healthcare: a scoping review of definitions, influencing factors, and mitigation strategies
title_sort alarm fatigue in healthcare a scoping review of definitions influencing factors and mitigation strategies
topic Alarm fatigue
Patient safety
Nurses
Healthcare quality improvement
Well-being at work
url https://doi.org/10.1186/s12912-025-03369-2
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