Barriers to managing clinical alarms in intensive care units: a cross-sectional study

OBJECTIVE: to investigate the barriers to clinical alarm management according to nurses and nursing technicians and to examine characteristics of clinical alarm response in intensive care units. METHOD: a cross-sectional study was conducted in a hospital accredited by the Joint Commission International and the American Nurses Credentialing Center Magnet Recognition. A questionnaire was used to identify barriers to clinical alarm management and 84 hours of observation were carried out. RESULTS: 92 professionals participated (33 nurses; 59 nursing technicians). The perception of inadequate nursing staffing levels was more frequent among nurses (21.2%) than among nursing technicians (3.4%; p=0.006). Competition between clinical alarms and noise from other equipment was identified as similar among nurses (20; 60.6%) and nursing technicians (35; 53.9%; p=0.981). Frequent interruptions of activities were reported by nurses (6; 18.2%) and nursing technicians (17; 28.8%) (p=0.615). Forty-nine clinical alarms were recorded, with a mean response time of 2.5 minutes (SD 2.8) and three (6.1%) were ignored. CONCLUSION: several barriers to adequate management were identified, including human resources, environmental factors and work processes. Regarding care, alarms from multiparameter monitors predominated, responded to mainly by the nursing staff, with a low proportion of ignored clinical alarms.