ArticleHospital pediatrics2021
Physiologic Monitor Alarm Burden and Nurses' Subjective Workload in a Children's Hospital.
Article in Hospital pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Evaluation of an Educational Outreach and Audit and Feedback Program to Reduce Continuous Pulse Oximetry Use in Hospitalized Infants With Stable Bronchiolitis: A Nonrandomized Clinical Trial.JAMA network open · 2021Trial
- Correlations between monitor alarm workload and overall workload in Swedish emergency departments: a prospective multicenter cross-sectional study.BMC emergency medicine · 2026Article
- Alarm Management Competence in Clinical Nursing Practice: An Evolutionary Concept Analysis.Journal of nursing management · 2026Review
- Bridging the gap: the mediating role of self-efficacy in the impact of workload on core competencies among pediatric nurses.BMC nursing · 2025Article
- Wearable biosensors for pediatric hospitals: a scoping review.Pediatric research · 2025Article
- The Relationship Between Alarm Fatigue and Medical Error Tendency in Intensive Care Unit Nurses: The Mediating Affect of Role Overload.Nursing in critical care · 2025Article
- Alert design in the real world: a cross-sectional analysis of interruptive alerting at 9 academic pediatric health systems.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Workload in the Surgical Center: perceptions, activities and time spent by nurses.Revista latino-americana de enfermagem · 2025Article
- Continuous pulse oximetry monitoring in children hospitalized with bronchiolitis: A qualitative analysis of clinicians' justifications.Journal of hospital medicine · 2024Article
- MAN VERSUS MACHINE: PROVIDER DIRECTED VERSUS PRECISION AUTOMATED CRITICAL CARE MANAGEMENT IN A PORCINE MODEL OF DISTRIBUTIVE SHOCK.Shock (Augusta, Ga.) · 2024Article
- Performance comparison of 6 in-hospital patient monitoring systems in the detection and alarm of ventricular cardiac arrhythmias.Cardiovascular digital health journal · 2024Article
- Alarm burden and the nursing care environment: a 213-hospital cross-sectional study.BMJ open quality · 2023Article
- The impact of an intervention to improve intrapartum maternal vital sign monitoring and reduce alarm fatigue.American journal of obstetrics & gynecology MFM · 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
- Missed nursing care and its influencing factors among neonatal intensive care unit nurses in South Korea: a descriptive study.Child health nursing research · 2022Article
- The Alarm Burden of Excess Continuous Pulse Oximetry Monitoring Among Patients With Bronchiolitis.Journal of hospital medicine · 2021Article
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Authors and funding
13 authors.
Funding
Abstract
BACKGROUND AND
objectivesPhysiologic monitor alarms occur at high rates in children's hospitals; ≤1% are actionable. The burden of alarms has implications for patient safety and is challenging to measure directly. Nurse workload, measured by using a version of the National Aeronautics and Space Administration Task Load Index (NASA-TLX) validated among nurses, is a useful indicator of work burden that has been associated with patient outcomes. A recent study revealed that 5-point increases in the NASA-TLX score were associated with a 22% increased risk in missed nursing care. Our objective was to measure the relationship between alarm count and nurse workload by using the NASA-TLX.
methodsWe conducted a repeated cross-sectional study of pediatric nurses in a tertiary care children's hospital to measure the association between NASA-TLX workload evaluations (using the nurse-validated scale) and alarm count in the 2 hours preceding NASA-TLX administration. Using a multivariable mixed-effects regression accounting for nurse-level clustering, we modeled the adjusted association of alarm count with workload.
resultsThe NASA-TLX score was assessed in 26 nurses during 394 nursing shifts over a 2-month period. In adjusted regression models, experiencing >40 alarms in the preceding 2 hours was associated with a 5.5 point increase (95% confidence interval 5.2 to 5.7;
conclusionAlarm count in the preceding 2 hours is associated with a significant increase in subjective nurse workload that exceeds the threshold associated with increased risk of missed nursing care and potential patient harm.
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