ArticlePloS one2018
Testing physiologic monitor alarm customization software to reduce alarm rates and improve nurses' experience of alarms in a medical intensive care unit.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 51 citations in OpenAlex.
- Integrated pulmonary index during procedural sedation and analgesia: A cluster-randomized trial.Journal of advanced nursing · 2025Trial
- Digital Gaze and Vicarious Trauma Among Intensive Care Unit Nurses in Alarm-Monitoring Ecologies: Qualitative Interview Study.Journal of medical Internet research · 2026Article
- Alarm fatigue among critical care unit and emergency room nurses: a multicentre cross-sectional study in Iran.BMJ open · 2026Article
- Hospital Digital Transformation, Nursing Data Burden, and Leadership and Governance Capacity: A Critical Narrative Review.Journal of nursing management · 2026Review
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- Enhancing Patient Safety Through an Integrated Internet of Things Patient Care System: Large Quasi-Experimental Study on Fall Prevention.Journal of medical Internet research · 2024Article
- The effect of intelligent management interventions in intensive care units to reduce false alarms: An integrative review.International journal of nursing sciences · 2024Review
- Extension of an ICU-based noninvasive model to predict latent shock in the emergency department: an exploratory study.Frontiers in cardiovascular medicine · 2024Article
- Role of artificial intelligence in haemodynamic monitoring.Indian journal of anaesthesia · 2024Article
- Alarm burden and the nursing care environment: a 213-hospital cross-sectional study.BMJ open quality · 2023Article
- The impact of the use of continuous pulse oximetry monitoring to monitor patients at high risk of respiratory depression on nursing practice.Nursing open · 2023Article
- A brief questionnaire for measuring alarm fatigue in nurses and physicians in intensive care units.Scientific reports · 2023Review
- Intensive care unit nurses' perceptions and practices regarding clinical alarms: A descriptive study.Nursing open · 2023Observational
- Staff perspectives on the influence of patient characteristics on alarm management in the intensive care unit: a cross-sectional survey study.BMC health services research · 2023Article
- Clinician Perspectives on Specifications for Metrics to Inform Pediatric Alarm Management.Biomedical instrumentation & technology · 2023Article
- Pediatric Characteristics Associated With Higher Rates of Monitor Alarms.Biomedical instrumentation & technology · 2023Article
- Assessment of Remote Vital Sign Monitoring and Alarms in a Real-World Healthcare at Home Dataset.Bioengineering (Basel, Switzerland) · 2022Article
- A pilot study to investigate real-time digital alerting from wearable sensors in surgical patients.Pilot and feasibility studies · 2022Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinicians in intensive care units experience alarm fatigue related to frequent false and non-actionable alarms produced by physiologic monitors. To reduce non-actionable alarms, alarm settings may need to be customized for individual patients; however, nurses may not customize alarms because of competing demands and alarm fatigue.
objectiveTo examine the effectiveness and acceptance of physiologic monitor software to support customization of alarms.
methodsThis pre/post intervention study was conducted in a 56-bed medical intensive care unit. IntelliVue® Alarm Advisor customization support software for alarm limit violations was installed on all monitors and education on its use provided. For 2 months before and after implementation of the software, data were collected on patient characteristics from the electronic health record, alarm counts and duration from the monitoring system, and nurses' experience of alarms from a survey.
resultsMedium-priority heart rate, respiratory rate, and arterial pressure alarms were significantly reduced after software implementation (9.3%, 11.8%, and 15.9% reduction respectively; p<0.001 for all). The duration of these alarms was also significantly shorter (7.8%, 13.3%, and 9.3% reduction respectively; p<0.05 for all). The number and duration of SpO2 alarms did not decrease (p>0.05 for both). Patients post-intervention had worse Glasgow Coma Scale scores (p = 0.014), but otherwise were comparable to those pre-intervention. Nurses reported less time spent on non-actionable alarms post-intervention than pre-intervention (p = 0.026). Also lower post-intervention were the proportions of nurses who reported that alarms disturbed their workflow (p = 0.027) and who encountered a situation where an important alarm was ignored (p = 0.043). The majority (>50%) agreed that the software supported setting appropriate alarm limits and was easy to use.
conclusionAlarm customization software was associated with a reduction in alarms. Use of software to support nurses' recognition of trends in patients' alarms and facilitate changes to alarm settings may add value to alarm reduction initiatives.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.