A comprehensive cross-sectional study of bedside monitor alarm characteristics and alarm load across hospital units.

Bedside physiologic monitor alarms negatively contribute to clinician cognitive burden and patient wellbeing in hospital intermediate (IMCU) and intensive (ICU) care units. This was a cross-sectional study to characterize the types, sources, annunciation modality and prevalence of alarms generated by bedside patient monitors, as well as their distributions and hourly alarm load across 3 ICUs and 1 IMCU. Analyzing > 2 million monitoring hours from 17,442 patient encounters (59 ± 18 years, 14% Black, 43% female) over 5 years, we identified 65.6 million alarms. Of all alarms, 74% were silent while 26% were audible. Most alarms (88%) were technical, unrelated to patient condition, while 12% were physiologic, suggesting clinical instability. Among audible alarms, 68% arose from technical issues. The IMCU averaged 5 audible alarms per patient-hour, of which 67% were technical. ICUs experienced up to 10 audible alarms per patient-hour, with 54% of them technical. This comprehensive study of monitoring alerts shows that alarms in IMCUs and ICUs are predominantly technical, highlighting opportunities to refine monitoring technologies and management strategies. Such improvements would help clinicians focus on alarms signaling true changes in patient physiologic status and reduce the cognitive burden of frequent alarms, which can contribute to alarm fatigue and worsen patient outcomes.