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智慧护理应对重症监护病房护士报警疲劳

Smart care for dealing with nurses' alarm fatigue in the intensive care unit.

机构信息

Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.

出版信息

J Nurs Scholarsh. 2023 Jul;55(4):825-833. doi: 10.1111/jnu.12870. Epub 2023 Jan 11.

Abstract

BACKGROUND

Alarm fatigue is a condition in which a person experiences sensory overload or desensitization in exposure to frequent non-actionable alarms. Nurses are the main users of alarms in health care and their behaviors for alarm management influence the occurrence of alarm fatigue.

OBJECTIVES

This qualitative research aimed to explore strategies used by nurses in dealing with nurses' alarm fatigue in the intensive care unit (ICU).

DESIGN

Qualitative research was carried out. Eighteen nurses working in ICUs were selected purposefully and were invited to take part in individual semi-structured interviews. Collected data were analyzed using content analysis for developing categories and subcategories.

SETTING

Twelve ICUs in ten hospitals in four urban areas of Iran.

RESULTS

The research's main category was "smart care" consisting of two categories of "technologic actions" and "non-technologic actions." Also, six subcategories were developed: "identifying the cause and taking timely actions", "personalized alarm settings", "reducing the number of unnecessary alarms", "effective teamwork", "improving the physical environment and ward arrangement", and "self-calmness".

CONCLUSION

Smart care by nurses included a set of active and proactive interventions developed through thinking and reflection and the use of information, skills, and experiences in order to manage exposure to alarm fatigue. Strategies used by nurses to prevent alarm fatigue can reduce the physical and psychological burden caused by frequent exposure to alarms in the ICU and consequently can have direct impacts on the quality and safety of nursing care.

CLINICAL RELEVANCE

Nurses in the healthcare process often experience alarm fatigue that is influenced by the cultural-contextual aspect of care and the care environment. Smart care in terms of technologic and non-technologic actions helps with the prevention of alarm fatigue.

摘要

背景

报警疲劳是指人在频繁接触无实际操作意义的警报时,出现感觉超负荷或脱敏的状态。护士是医疗保健中警报的主要使用者,他们的报警管理行为会影响报警疲劳的发生。

目的

本定性研究旨在探讨护士在重症监护病房(ICU)中应对护士报警疲劳的策略。

设计

开展定性研究。采用目的抽样法选取 18 名在 ICU 工作的护士,邀请他们参加个人半结构式访谈。采用内容分析法对收集的数据进行分析,以形成类别和子类别。

地点

伊朗四个城市的十个医院的 12 个 ICU。

结果

研究的主要类别是“智能护理”,包括“技术措施”和“非技术措施”两个类别。此外,还开发了六个亚类:“识别原因并及时采取行动”、“个性化报警设置”、“减少不必要的报警数量”、“有效团队合作”、“改善物理环境和病房布局”和“自我平静”。

结论

护士的智能护理包括一系列主动和积极的干预措施,这些措施是通过思考和反思以及利用信息、技能和经验来制定的,目的是管理对报警疲劳的暴露。护士用来预防报警疲劳的策略可以减轻 ICU 中频繁接触警报所带来的身体和心理负担,从而直接影响护理质量和安全。

临床相关性

在医疗保健过程中,护士经常会经历报警疲劳,这受到护理的文化背景和护理环境的影响。从技术和非技术措施方面进行智能护理有助于预防报警疲劳。

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