Evidence map›Paper›PMID 38888941›Full record

ArticleJMIR human factors2024

Alarm Management in Intensive Care: Qualitative Triangulation Study.

Lina Mosch, Meltem Sümer, Anne Rike Flint, Markus Feufel, Felix Balzer, Frauke Mörike, Akira-Sebastian Poncette

Abstract read
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In one paragraph

Article in JMIR human factors, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Lina MoschInstitute of Medical Informatics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.ORCID 0000-0003-3154-2745
Meltem SümerDivision of Ergonomics, Department of Psychology and Ergonomics (IPA), Technische Universität Berlin, Berlin, Germany.ORCID 0009-0009-3274-8156
Anne Rike FlintInstitute of Medical Informatics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.ORCID 0000-0002-1414-5812
Markus FeufelDivision of Ergonomics, Department of Psychology and Ergonomics (IPA), Technische Universität Berlin, Berlin, Germany.ORCID 0000-0003-0563-8831
Felix BalzerInstitute of Medical Informatics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.ORCID 0009-0001-9839-4663
Frauke Mörike *Division of Ergonomics, Department of Psychology and Ergonomics (IPA), Technische Universität Berlin, Berlin, Germany.ORCID 0000-0001-6452-3853
Akira-Sebastian Poncette *Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.ORCID 0000-0003-4627-7016

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe high number of unnecessary alarms in intensive care settings leads to alarm fatigue among staff and threatens patient safety. To develop and implement effective and sustainable solutions for alarm management in intensive care units (ICUs), an understanding of staff interactions with the patient monitoring system and alarm management practices is essential.

objectiveThis study investigated the interaction of nurses and physicians with the patient monitoring system, their perceptions of alarm management, and smart alarm management solutions.

methodsThis explorative qualitative study with an ethnographic, multimethods approach was conducted in an ICU of a German university hospital. Using triangulation in data collection, 102 hours of field observations, 12 semistructured interviews with ICU staff members, and the results of a participatory task were analyzed. The data analysis followed an inductive, grounded theory approach.

resultsNurses and physicians reported interacting with the continuous vital sign monitoring system for most of their work time and tasks. There were no established standards for alarm management; instead, nurses and physicians stated that alarms were addressed through ad hoc reactions, a practice they viewed as problematic. Staff members' perceptions of intelligent alarm management varied, but they highlighted the importance of understandable and traceable suggestions to increase trust and cognitive ease.

conclusionsStaff members' interactions with the omnipresent patient monitoring system and its alarms are essential parts of ICU workflows and clinical decision-making. Alarm management standards and workflows have been shown to be deficient. Our observations, as well as staff feedback, suggest that changes are warranted. Solutions for alarm management should be designed and implemented with users, workflows, and real-world data at the core.

Indexed as

Clinical AlarmsIntensive Care UnitsQualitative ResearchAdultAttitude of Health PersonnelCritical CareFemaleGermanyHumansMaleMiddle AgedMonitoring, Physiologicalarmalarmsartificial intelligenceattitudeattitudesdigital healthethnographicethnographyEuropeEuropeanexperienceexperiencesGermanGermanygrounded theoryICUintelligentintensive careintensive care unitinterviewinterviewsopinionopinionspatient-centered careperceptionperceptionsperspectiveperspectivesqualitativetechnological innovationtransdisciplinary research

Identifiers

PMID38888941
PMCPMC11220431

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Registered trials

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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.