Ramlaul A, Chironda G, Brysiewicz P
School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
South Afr J Crit Care. 2021 Aug 6;37(2). doi: 10.7196/SAJCC.2021.v37i2.469. eCollection 2021.
Advances in technology have facilitated the implementation of improved alarm management systems in the healthcare sector. There is a need to identify challenges encountered by intensive care unit (ICU) nurses with clinical alarm management systems in South Africa (SA) to ensure utilisation of these technological resources for patient safety.
To investigate how intensive care nurses respond to clinical alarms for patient safety in a selected hospital in KwaZulu-Natal Province, SA.
A descriptive, non-experimental research design using the census sampling strategy was used to invite 120 nurses from four ICUs to complete an adapted, structured questionnaire. Descriptive statistics were used to analyse the data.
We had 91 respondents who completed the questionnaires (response rate of 75.8%). The majority of the respondents (85.7%) strongly knew the purpose of clinical alarms and 45.1% strongly felt confident about adjusting and monitoring the clinical alarms. More than half of the nurses (53.8 %) agreed to the existence of nuisance alarms that disrupted patient care (46.7%) and contributed to lack of responses (52.7%). While 76.9% strongly agreed with alarm sounds and displays to differentiate the priority of the alarms, 75.8% strongly agreed to the existence of proper documentation on setting alarms that are appropriate for each patient. The most frequent barriers were difficulty in setting alarms properly (51.6%) and lack of training on alarm systems (47.8%).
The complexity in setting the alarms, limited training and existence of false alarms was evident. Alarm-specific training is required to keep intensive care nurses updated with changes in technology to ensure patient safety.
The findings of this present study highlighted the importance of understanding the alarm management system within the ICU environment of the healthcare sector in SA. Technological improvements, specialised trainings and clear clinical policies for alarm management are essential to improve patient safety.
技术进步推动了医疗保健领域改进警报管理系统的实施。有必要确定南非（SA）重症监护病房（ICU）护士在临床警报管理系统方面遇到的挑战，以确保利用这些技术资源保障患者安全。
调查南非夸祖鲁 - 纳塔尔省一家选定医院的重症监护护士如何应对临床警报以保障患者安全。
采用描述性、非实验性研究设计，运用普查抽样策略，邀请来自四个ICU的120名护士完成一份经过改编的结构化问卷。使用描述性统计分析数据。
我们有91名受访者完成了问卷（回复率为75.8%）。大多数受访者（85.7%）清楚了解临床警报的目的，45.1%对调整和监测临床警报有信心。超过一半的护士（53.8%）同意存在干扰警报，这些警报干扰了患者护理（46.7%）并导致反应不及时（52.7%）。虽然76.9%的人强烈同意警报声音和显示能区分警报优先级，但75.8%的人强烈同意存在针对为每位患者设置适当警报的正确文档记录。最常见的障碍是难以正确设置警报（51.6%）和缺乏警报系统培训（47.8%）。
设置警报的复杂性、培训有限以及误报的存在显而易见。需要针对警报进行专门培训，以使重症监护护士跟上技术变化，确保患者安全。
本研究结果凸显了在南非医疗保健领域ICU环境中理解警报管理系统的重要性。技术改进、专门培训以及明确的警报管理临床政策对于提高患者安全至关重要。
