Call for Decision Support for Electrocardiographic Alarm Administration Among Neonatal Intensive Care Unit Staff: Multicenter, Cross-Sectional Survey

BackgroundPrevious studies have shown that electrocardiographic (ECG) alarms have high sensitivity and low specificity, have underreported adverse events, and may cause neonatal intensive care unit (NICU) staff fatigue or alarm ignoring. Moreover, prolonged noise stimuli in h...

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Main Authors: Xiaoli Tang, Xiaochen Yang, Jiajun Yuan, Jie Yang, Qian Jin, Hanting Zhang, Liebin Zhao, Weiwei Guo
Format: Article
Language:English
Published: JMIR Publications 2024-12-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2024/1/e60944
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author Xiaoli Tang
Xiaochen Yang
Jiajun Yuan
Jie Yang
Qian Jin
Hanting Zhang
Liebin Zhao
Weiwei Guo
author_facet Xiaoli Tang
Xiaochen Yang
Jiajun Yuan
Jie Yang
Qian Jin
Hanting Zhang
Liebin Zhao
Weiwei Guo
author_sort Xiaoli Tang
collection DOAJ
description BackgroundPrevious studies have shown that electrocardiographic (ECG) alarms have high sensitivity and low specificity, have underreported adverse events, and may cause neonatal intensive care unit (NICU) staff fatigue or alarm ignoring. Moreover, prolonged noise stimuli in hospitalized neonates can disrupt neonatal development. ObjectiveThe aim of the study is to conduct a nationwide, multicenter, large-sample cross-sectional survey to identify current practices and investigate the decision-making requirements of health care providers regarding ECG alarms. MethodsWe conducted a nationwide, cross-sectional survey of NICU staff working in grade III level A hospitals in 27 Chinese provinces to investigate current clinical practices, perceptions, decision-making processes, and decision-support requirements for clinical ECG alarms. A comparative analysis was conducted on the results using the chi-square, Kruskal-Wallis, or Mann-Whitney U tests. ResultsIn total, 1019 respondents participated in this study. NICU staff reported experiencing a significant number of nuisance alarms and negative perceptions as well as practices regarding ECG alarms. Compared to nurses, physicians had more negative perceptions. Individuals with higher education levels and job titles had more negative perceptions of alarm systems than those with lower education levels and job titles. The mean difficulty score for decision-making about ECG alarms was 2.96 (SD 0.27) of 5. A total of 62.32% (n=635) respondents reported difficulty in resetting or modifying alarm parameters. Intelligent module–assisted decision support systems were perceived as the most popular form of decision support. ConclusionsThis study highlights the negative perceptions and strong decision-making requirements of NICU staff related to ECG alarm handling. Health care policy makers must draw attention to the decision-making requirements and provide adequate decision support in different forms.
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spelling doaj-art-fbba9db6d4744da0a3d681ec249c6fe62025-08-20T01:57:04ZengJMIR PublicationsJournal of Medical Internet Research1438-88712024-12-0126e6094410.2196/60944Call for Decision Support for Electrocardiographic Alarm Administration Among Neonatal Intensive Care Unit Staff: Multicenter, Cross-Sectional SurveyXiaoli Tanghttps://orcid.org/0000-0003-4585-263XXiaochen Yanghttps://orcid.org/0009-0005-1663-7764Jiajun Yuanhttps://orcid.org/0000-0002-9576-7890Jie Yanghttps://orcid.org/0000-0002-7691-0241Qian Jinhttps://orcid.org/0009-0002-5552-5835Hanting Zhanghttps://orcid.org/0009-0000-5991-2408Liebin Zhaohttps://orcid.org/0009-0000-0946-3413Weiwei Guohttps://orcid.org/0000-0001-9738-0860 BackgroundPrevious studies have shown that electrocardiographic (ECG) alarms have high sensitivity and low specificity, have underreported adverse events, and may cause neonatal intensive care unit (NICU) staff fatigue or alarm ignoring. Moreover, prolonged noise stimuli in hospitalized neonates can disrupt neonatal development. ObjectiveThe aim of the study is to conduct a nationwide, multicenter, large-sample cross-sectional survey to identify current practices and investigate the decision-making requirements of health care providers regarding ECG alarms. MethodsWe conducted a nationwide, cross-sectional survey of NICU staff working in grade III level A hospitals in 27 Chinese provinces to investigate current clinical practices, perceptions, decision-making processes, and decision-support requirements for clinical ECG alarms. A comparative analysis was conducted on the results using the chi-square, Kruskal-Wallis, or Mann-Whitney U tests. ResultsIn total, 1019 respondents participated in this study. NICU staff reported experiencing a significant number of nuisance alarms and negative perceptions as well as practices regarding ECG alarms. Compared to nurses, physicians had more negative perceptions. Individuals with higher education levels and job titles had more negative perceptions of alarm systems than those with lower education levels and job titles. The mean difficulty score for decision-making about ECG alarms was 2.96 (SD 0.27) of 5. A total of 62.32% (n=635) respondents reported difficulty in resetting or modifying alarm parameters. Intelligent module–assisted decision support systems were perceived as the most popular form of decision support. ConclusionsThis study highlights the negative perceptions and strong decision-making requirements of NICU staff related to ECG alarm handling. Health care policy makers must draw attention to the decision-making requirements and provide adequate decision support in different forms.https://www.jmir.org/2024/1/e60944
spellingShingle Xiaoli Tang
Xiaochen Yang
Jiajun Yuan
Jie Yang
Qian Jin
Hanting Zhang
Liebin Zhao
Weiwei Guo
Call for Decision Support for Electrocardiographic Alarm Administration Among Neonatal Intensive Care Unit Staff: Multicenter, Cross-Sectional Survey
Journal of Medical Internet Research
title Call for Decision Support for Electrocardiographic Alarm Administration Among Neonatal Intensive Care Unit Staff: Multicenter, Cross-Sectional Survey
title_full Call for Decision Support for Electrocardiographic Alarm Administration Among Neonatal Intensive Care Unit Staff: Multicenter, Cross-Sectional Survey
title_fullStr Call for Decision Support for Electrocardiographic Alarm Administration Among Neonatal Intensive Care Unit Staff: Multicenter, Cross-Sectional Survey
title_full_unstemmed Call for Decision Support for Electrocardiographic Alarm Administration Among Neonatal Intensive Care Unit Staff: Multicenter, Cross-Sectional Survey
title_short Call for Decision Support for Electrocardiographic Alarm Administration Among Neonatal Intensive Care Unit Staff: Multicenter, Cross-Sectional Survey
title_sort call for decision support for electrocardiographic alarm administration among neonatal intensive care unit staff multicenter cross sectional survey
url https://www.jmir.org/2024/1/e60944
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