Appl Clin Inform 2024; 15(03): 533-543
DOI: 10.1055/a-2297-4652
Research Article

Machine Alarm Fatigue among Hemodialysis Nurses in 29 Tertiary Hospitals

Chaonan Sun
1   School of Nursing, Dalian Medical University, Dalian, Liaoning, China
,
Meirong Bao
2   Department of Otolaryngology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
,
Congshan Pu
1   School of Nursing, Dalian Medical University, Dalian, Liaoning, China
,
Xin Kang
1   School of Nursing, Dalian Medical University, Dalian, Liaoning, China
,
Yiping Zhang
1   School of Nursing, Dalian Medical University, Dalian, Liaoning, China
,
Xiaomei Kong
3   Department of Traditional Chinese Medicine, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
,
Rongzhi Zhang
4   Department of Center for Hemodialysis, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
› Author Affiliations

Abstract

Objectives To understand the status quo and related influencing factors of machine alarm fatigue of hemodialysis nurses in tertiary hospitals in Liaoning Province.

Methods This cross-sectional study employed convenience sampling to select 460 nurses from 29 tertiary hospitals in Liaoning Province, who are involved in hemodialysis care. Surveys were conducted using the General Information Questionnaire, Alarm Fatigue Scale, National Aeronautics and Space Administration Task Load Index, and Maslach Burnout Inventory Scale.

Results The overall machine alarm fatigue score for 460 hemodialysis nurses from 29 tertiary hospitals in Liaoning Province was 17.04 ± 3.21, indicating a moderate level. The multiple linear regression analysis shows that years of experience in hemodialysis nursing, the number of patients managed per shift, whether specialized nursing training has been received, self-reported health status, emotional exhaustion, and workload have statistically significant associations with alarm fatigue among hemodialysis nurses (p < 0.05). Among them, the years of experience in hemodialysis nursing are negatively correlated with alarm fatigue among hemodialysis nurses, whereas the number of patients managed per shift and workload are positively correlated with alarm fatigue among hemodialysis nurses.

Conclusion This study indicates that certain demographic factors, workload, and occupational burnout are associated with machine alarm fatigue among hemodialysis nurses. Therefore, hemodialysis-related managers should establish a Machine Alarm Management System, implement Personalized Thresholds and Delayed Alarms, ensure reasonable staffing arrangements, improve compassion fatigue, and enhance anticipatory care. Our findings have implications for improving the health and well-being of hemodialysis nurses, providing a conducive environment for professional training in hemodialysis, and ultimately addressing the current situation of machine alarm fatigue among hemodialysis nurses.

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was reviewed by the Second Hospital of Dalian Medical University Review Board.


Co-first author.




Publication History

Received: 03 December 2023

Accepted: 26 March 2024

Accepted Manuscript online:
01 April 2024

Article published online:
10 July 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Fila B. Quality indicators of vascular access procedures for hemodialysis. Int Urol Nephrol 2021; 53 (03) 497-504
  • 2 Cao W, Feng H, Zeng X. et al. Preliminary discussion on cost and quality assessment of primary dialysis units using big data. Chin J Blood Purification 2017; 16 (06) 383-386
  • 3 Wu H, Wang K, Zheng Q. Thoughts on “independent hemodialysis centers inclusion in medical insurance management”. China Social Security 2018; (07) 40-41
  • 4 Zhao J, Lu Y, Ding L. et al. Analysis and guidance of 3518 cases of CRRT treatment failure alarms. Chin J Blood Purification 2014; 13 (04) 353-354
  • 5 ECRI Institute. Top 10 health technology hazards for 2015. Accessed on January 22, 2017 at: http://www.ecri.org/2015hazar -ds
  • 6 Wang D, Zhang Y, Luo L. et al. Investigation on the status and influencing factors of alarm fatigue in ICU nurses' medical equipment. J Nurs (Luton) 2018; 33 (13) 19-21
  • 7 Harris RM, Manavizadeh J, McPherson DJ, Smith L. Do you hear bells? The increasing problem of alarm fatigue. Pa Nurse 2011; 66 (01) 10-13
  • 8 Oliveira AEC, Machado AB, Santos EDD, Almeida ÉB. Alarm fatigue and the implications for patient safety. Rev Bras Enferm 2018; 71: 3035-3040
  • 9 Joinson C. Coping with compassion fatigue. Nursing 1992; 22 (04) 116-120 , 118–119, 120
  • 10 Rayo MF, Moffatt-Bruce SD. Diagnosing and treating “alarm fatigue”: pragmatic and evidence-based approaches needed. Jt Comm J Qual Patient Saf 2016; 42 (07) 291-292
  • 11 Ryherd EE, Waye KP, Ljungkvist L. Characterizing noise and perceived work environment in a neurological intensive care unit. J Acoust Soc Am 2008; 123 (02) 747-756
  • 12 Ding X. Analysis of the reasons for the decreased sensitivity of young nurses to monitor alarms and countermeasures. General Nursing 2018; 16 (10) 1239-1240
  • 13 Kim SJ, Sung MS. Subjective symptoms on fatigue in hospital nurses. J Korean Acad Nurs 1998; 28 (04) 908-919
  • 14 Wei Chen FX, Yulan X, Fan H, Qi H, Ye D. Multifactor logistic regression analysis and improvement measures of alarm fatigue in our hospital's monitor. Chin Med Equipment 2020; 35 (01) 138-144
  • 15 Hart SG, Staveland LE. Development of NASA-TLX (Task Load Index): results of empirical and theoretical research. Adv Psychol 1988; 52: 139-183
  • 16 Liang L, Zhao L, Deng J. et al. Chinese version of the NASA-TLX Scale: translation and validation. Nurs Res 2019; 33 (05) 734-737
  • 17 Maslach C. The measurement of experienced burnout. J Occupl Behav 1981; 2 (02) 99-113
  • 18 Wang L, Liu H. The status quo of alarm fatigue in hemodialysis room nurses and its influencing factors. Int J Nurs (N Y) 2018; 37 (22) 3051-3054
  • 19 Lewandowska K, Weisbrot M, Cieloszyk A, Mędrzycka-Dąbrowska W, Krupa S, Ozga D. Impact of alarm fatigue on the work of nurses in an intensive care environment-a systematic review. Int J Environ Res Public Health 2020; 17 (22) 8409
  • 20 Karahan A, Kav S, Çevik B, Çıtak EA, Uğurlu Z, Fulser B. Alarm fatigue among nurses working in intensive care and other inpatient clinics. Work 2023; 76 (02) 793-801
  • 21 Ding S, Huang X, Sun R. et al. The relationship between alarm fatigue and burnout among critical care nurses: a cross-sectional study. Nurs Crit Care 2023; 28 (06) 940-947
  • 22 Luo L, Wang Y, Yang M. et al. Study on the status and influencing factors of ICU nurses' alarm fatigue. General Nursing 2022; 20 (16) 2166-2170
  • 23 Yin Q. Research progress on alarm fatigue in ICU medical staff. Nurs Res 2018; 32 (21) 3325-3328
  • 24 Jiang S. Physical injury causes and protective measures for hemodialysis room nurses. Worlds Latest Med Inform Digest 2019; 19 (34) 203-206
  • 25 Yin H, Lan C, Zhou Q. Investigation and analysis of stress sources in 258 blood purification nurses in Jiangxi Province. Jiangxi Medicine 2019; 54 (04) 402-404
  • 26 Edworthy J, Reid S, Peel K. et al. The impact of workload on the ability to localize audible alarms. Appl Ergon 2018; 72: 88-93
  • 27 Hayes B, Bonner A, Douglas C. Haemodialysis work environment contributors to job satisfaction and stress: a sequential mixed methods study. BMC Nurs 2015; 14: 58
  • 28 Koomen E, Webster CS, Konrad D. et al. Reducing medical device alarms by an order of magnitude: a human factors approach. Anaesth Intensive Care 2021; 49 (01) 52-61
  • 29 Wei A, Zhang H, Yin J, Liu W, Yan L. A design of smart alarm management system of ICU. China Med Equipment 2018; 15 (11) 133-135
  • 30 Short K, Chung Jr YJ. Solving alarm fatigue with smartphone technology. Nursing 2019; 49 (01) 52-57
  • 31 Varisco G, van de Mortel H, Cabrera-Quiros L. et al. Optimisation of clinical workflow and monitor settings safely reduces alarms in the NICU. Acta Paediatr 2021; 110 (04) 1141-1150
  • 32 Claudio D, Deb S, Diegel E. A framework to assess alarm fatigue indicators in critical care staff. Crit Care Explor 2021; 3 (06) e0464
  • 33 Graham KC, Cvach M. Monitor alarm fatigue: standardizing use of physiological monitors and decreasing nuisance alarms. Am J Crit Care 2010; 19 (01) 28-34 , quiz 35
  • 34 Roodaki H, Navab N, Eslami A, Stapleton C, Navab N. SonifEye: sonification of visual information using physical modeling sound synthesis. IEEE Trans Vis Comput Graph 2017; 23 (11) 2366-2371
  • 35 Poole S, Shah N. Addressing vital sign alarm fatigue using personalized alarm thresholds. Pac Symp Biocomput 2018; 23: 472-483
  • 36 Xue Y, Zhong J, Zheng J. Application of multidisciplinary team on reducing ECG monitor alarm fatigue of nurses in cardiac surgery ICU. J Nurs Adm 2018; 18 (08) 601
  • 37 Bridi AC, Louro TQ, da Silva RC. Clinical alarms in intensive care: implications of alarm fatigue for the safety of patients. Rev Lat Am Enfermagem 2014; 22 (06) 1034-1040
  • 38 Bi J, Yin X, Li H. et al. Effects of monitor alarm management training on nurses' alarm fatigue: a randomised controlled trial. J Clin Nurs 2020; 29 (21–22): 4203-4216
  • 39 Chen T. Research progress on the intervention of ICU instrument alarm. Publ Med Forum Magazine 2017; 21 (15) 1971-1972
  • 40 Kelly L, Runge J, Spencer C. Predictors of compassion fatigue and compassion satisfaction in acute care nurses. J Nurs Scholarsh 2015; 47 (06) 522-528
  • 41 Sacco TL, Ciurzynski SM, Harvey ME, Ingersoll GL. Compassion satisfaction and compassion fatigue among critical care nurses. Crit Care Nurse 2015; 35 (04) 32-43 , quiz 1p, 43
  • 42 Storm J, Chen HC. The relationships among alarm fatigue, compassion fatigue, burnout and compassion satisfaction in critical care and step-down nurses. J Clin Nurs 2021; 30 (3-4): 443-453
  • 43 Bi S. Application of predictive nursing in orthopedics nursing. Nursing Res China 2017; 31 (06) 754-755
  • 44 Nian S, Li H, Li E, Shen Q. Predictive nursing in the prevention of hypoglycemia in hemodialysis. J Nurs Adm 2020; 20 (08) 597
  • 45 Ruskin KJ, Hueske-Kraus D. Alarm fatigue: impacts on patient safety. Curr Opin Anaesthesiol 2015; 28 (06) 685-690
  • 46 Zhou Q, Hu T, Yi R. To observe the application effect of predictive nursing in preventing extracorporeal circulation tube plugging. Today Nurse 2021; 28 (26) 98-99