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American Journal of Critical Care. 2008;17: 36-41
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A National Online Survey on the Effectiveness of Clinical Alarms

By Denise M. Korniewicz, RN, PhD, Tobey Clark, MS, CCE and Yadin David, EdD, CCE, PE, HCSP. Denise M. Korniewicz is a professor at the University of Miami School of Nursing and Health Studies, Miami, Florida. Tobey Clark is director of instrumentation and technical services at the University of Vermont, Burlington. Yadin David is director of biomedical engineering at Texas Children’s Hospital, Houston, Texas.

Corresponding author: Denise M. Korniewicz, RN, PhD, FAAN, Professor, University of Miami, School of Nursing and Health Studies, PO Box 248153, Coral Gables, FL 33124 (e-mail: dkorniewicz{at}miami.edu).

Purpose To develop a national online survey to be administered by the American College of Clinical Engineers Healthcare Technology Foundation to hospitals and healthcare workers to determine the problems associated with alarms in hospitals.

Methods An online survey was developed by a 16-member task force representing professionals from clinical engineering, nursing, and technology to evaluate the reasons health-care workers do not respond to clinical alarms.

Results A total of 1327 persons responded to the survey; most (94%) worked in acute care hospitals. About half of the respondents were registered nurses (51%), and one-third of respondents (31%) worked in a critical care unit. Most respondents (>90%) agreed or strongly agreed with the statements covering the purpose of clinical alarms and the need for prioritized and easily differentiated audible and visual alarms. Likewise, many respondents identified nuisance alarms as problematic; most agreed or strongly agreed that the alarms occur frequently (81%), disrupt patient care (77%), and can reduce trust in alarms and cause caregivers to disable them (78%).

Conclusions Effective clinical alarm management relies on (1) equipment designs that promote appropriate use, (2) clinicians who take an active role in learning how to use equipment safely over its full range of capabilities, and (3) hospitals that recognize the complexities of managing clinical alarms and devote the necessary resources to develop effective management schemes.


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