Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway; Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia.
Aust Crit Care. 2023 Nov;36(6):980-988. doi: 10.1016/j.aucc.2022.12.004. Epub 2023 Feb 1.
The aim of this study was to explore the process of how nurses experienced and dealt with alarm fatigue in intensive care units based on Iranian nurses' perceptions and experiences.
Alarm fatigue is the overstimulation of senses due to the constant ringing of alarms in intensive care units. It is associated with nurses' desensitization to critical alarms that can directly influence patient safety and quality of care.
A qualitative exploratory study using the grounded theory approach by Strauss and Corbin was carried out. Participants were 20 nurses working in intensive care units. The sampling process was started purposively and continued theoretically. Data were collected using semi-structured, in-depth, and individual interviews and continued to data saturation. The constant comparative analysis approach was used consisting of the following steps: open coding, developing concepts, analysing the context, entering the process into data analysis, integrating categories.
The participants' main concern in the exposure to alarm fatigue was 'threat to personal balance'. The core category in this research was 'trying to create a holistic balance', which reflected a set of strategies that the nurses consistently and continuously used to deal with alarm fatigue and consisted of four main categories as follows: 'smart care', 'deliberate balancing', 'conditional prioritisation', and 'negligent performance'. Threat to personal balance was strengthened by 'inappropriate circuit of individual roles', 'distortion of the organisational structure', and 'insecurity of the infrastructure'. The consequences of this process was harm to the patient, burnout among nurse, and damage to the healthcare organisation.
The research findings have practical implications for healthcare management, policymaking, nursing education, research, and clinical practice. Mitigating staff shortages, improving staff competencies, enhancing nurses' authority for responding to alarms, modifying care routines, improving the physical environment, and removing problems related to alarm equipment can prevent alarm fatigue and its unappropriated consequences.
本研究旨在探讨伊朗护士对重症监护病房中警报疲劳的体验和应对过程。
警报疲劳是指由于重症监护病房中警报不断响起而导致的感官过度刺激。它与护士对关键警报的脱敏有关，这可能直接影响患者的安全和护理质量。
采用 Strauss 和 Corbin 的扎根理论方法进行定性探索性研究。参与者为 20 名在重症监护病房工作的护士。采用目的性抽样和理论性继续抽样。使用半结构化、深入的个人访谈收集数据，直至数据饱和。采用恒比分析方法，包括以下步骤：开放编码、发展概念、分析背景、将过程输入数据分析、整合类别。
参与者在接触警报疲劳时的主要关注点是“个人平衡受到威胁”。该研究的核心类别是“试图创造整体平衡”，反映了护士为应对警报疲劳而持续使用的一系列策略，包括四个主要类别：“明智护理”、“刻意平衡”、“有条件的优先级”和“疏忽表现”。个人角色的不适当循环、组织结构的扭曲和基础设施的不安全感加剧了个人平衡受到威胁。这一过程的后果是对患者造成伤害、护士倦怠和医疗保健组织受损。
研究结果对医疗保健管理、政策制定、护理教育、研究和临床实践具有实际意义。缓解人员短缺、提高人员能力、增强护士对警报的响应权、修改护理常规、改善物理环境以及解决与警报设备相关的问题，可以预防警报疲劳及其不当后果。
