Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
BMC Health Serv Res. 2023 Jul 5;23(1):729. doi: 10.1186/s12913-023-09688-x.
High rates of clinical alarms in the intensive care unit can result in alarm fatigue among staff. Individualization of alarm thresholds is regarded as one measure to reduce non-actionable alarms. The aim of this study was to investigate staff's perceptions of alarm threshold individualization according to patient characteristics and disease status.
This is a cross-sectional survey study (February-July 2020). Intensive care nurses and physicians were sampled by convenience. Data was collected using an online questionnaire.
Staff view the individualization of alarm thresholds in the monitoring of vital signs as important. The extent to which alarm thresholds are adapted from the normal range varies depending on the vital sign monitored, the reason for clinical deterioration, and the professional group asked. Vital signs used for hemodynamic monitoring (heart rate and blood pressure) were most subject to alarm individualizations. Staff are ambivalent regarding the integration of novel technological features into alarm management.
All relevant stakeholders, including clinicians, hospital management, and industry, must collaborate to establish a "standard for individualization," moving away from ad hoc alarm management to an intelligent, data-driven alarm management. Making alarms meaningful and trustworthy again has the potential to mitigate alarm fatigue - a major cause of stress in clinical staff and considerable hazard to patient safety.
The study was registered at ClinicalTrials.gov (NCT03514173) on 02/05/2018.
重症监护病房（ICU）中临床报警的高发生率可能导致医护人员出现报警疲劳。根据患者特征和疾病状态对报警阈值进行个体化设置被认为是减少非操作性报警的一种措施。本研究旨在调查医护人员对根据患者特征和疾病状态进行报警阈值个体化设置的看法。
这是一项横断面调查研究（2020 年 2 月至 7 月）。采用便利抽样法抽取 ICU 护士和医生作为研究对象。通过在线问卷收集数据。
医护人员认为对生命体征监测的报警阈值进行个体化设置很重要。从正常范围调整报警阈值的程度取决于所监测的生命体征、临床恶化的原因以及被询问的专业群体。用于血流动力学监测（心率和血压）的生命体征最容易进行报警个体化设置。医护人员对将新型技术特征纳入报警管理存在矛盾心理。
所有相关利益相关者，包括临床医生、医院管理层和行业，必须合作制定“个体化标准”，从临时的报警管理转变为智能、数据驱动的报警管理。使报警更有意义和值得信赖有可能减轻报警疲劳——这是临床工作人员压力的主要原因，也是患者安全的重大隐患。
该研究于 2018 年 5 月 2 日在 ClinicalTrials.gov（NCT03514173）上注册。
