Alarm fatigue is a practice problem that applies to hospitalized patients and the nurses who care for them. Addressing alarm fatigue is important to promote alarm safety and to decrease the risk of patient harm or death. The purpose of this study was to decrease alarm fatigue and improve alarm safety in a regional neonatal intensive care unit (RNICU). Guided by the conceptual model for alarm fatigue and alarm safety, this study addressed whether or not alarm management protocols designed to decrease false and nuisance alarms in the physiological monitoring of neonates improve alarm safety via decreased alarm burden and alarm fatigue as evidenced by statistically significant reductions in false and nuisance alarms. A quantitative, time series quasi-experimental design was used with 4 waves of data collection. One wave was baseline data collected preintervention, and 3 waves of data were postprotocol implementation to obtain an initial indication of sustainability. Alarm observation data collection sheets were developed and used to track numbers and types of alarms pre- and post-protocol implementation. The data analysis showed statistically significant decreases in both false alarms and nuisance alarms related to the physiological monitoring protocol and lead changing protocol. Overall, high protocol adherence was noted, and the total number of alarms per hour per bed was reduced by 42% (p < .001), 46% (p < .001), and 50% (p < .001) from baseline at Weeks 2, 4, and 6, respectively. Implications from this study include impact on practice and policy, direction for future study, and a call for social change to promote alarm safety in the care of neonates.

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Thesis ((MEng(ElectroSys))--University of South Australia, 1999

Thesis (M.S.)--Worcester Polytechnic Institute. / Keywords: acoustic agglomeration; smoke detector response; enhanced deposition; soot deposition. Includes bibliographical references (p. 146-147).

Based on cross-modal learning and multiple resources theory, human performance can be improved by receiving and processing additional streams of information from the environment. In alarm situations, alarm meanings need to be distinguishable from each other and learnable for users. In audible alarms, by manipulating the temporal characteristics of sounds different audible signals can be generated. However, in some cases such as in using discrete medical alarms, when there are too many audible signals to manage, changes in temporal characteristics may not generate discriminable signals that would be easy for listeners to learn. Multimodal displays can be developed to generate additional auditory, visual, and tactile stimuli for helping humans benefit from cross-modal learning and multiple attentional resources for a better understanding of the alarm situations. In designing multimodal alarm displays in work domains where the alarms are predominantly auditory-based and where accessing visual displays is not possible at all times, tactile displays can enhance the effectiveness of alarms by providing additional streams of information for understanding the alarms. However, because of low information density of tactile information presentation, the use of tactile alarms has been limited. In this thesis, by using human subjects, the learnability of auditory and tactile alarms, separately and together in an audio-tactile display were studied. The objective of the study was to test cross-modal learning when messages of an alarm (i.e. meaning, urgency level) were conveyed simultaneously in audible, tactile and audio-tactile alarm displays. The alarm signals were designed by using spatial characteristics of tactile, and temporal characteristics of audible signals separately in audible and tactile displays as well as together in an audio-tactile display. This study explored if using multimodal alarms (tactile and audible) would help learning unimodal (audible or tactile) alarm meanings and urgency levels. The findings of this study can help for design of more efficient discrete audio-tactile alarms that promote learnability of alarm meanings and urgency levels.

No description available.

Thesis (Ph.D)--Stanford University, 1999. / Title from pdf t.p. (viewed April 3, 2002). "March 1999." "Adminitrivia V1/Prg/19990407"--Metadata.

Thesis (M.S. of B.C. & I.F.M.)--College of Architecture, Georgia Institute of Technology, 2004. Directed by Linda Thomas-Mobley. / Includes bibliographical references (leaves 69-70).

Thesis (Ph. D.)--Victoria University (Melbourne, Vic.), 2007. / Includes bibliographical references.

Auditory alarm annoyance plagues clinicians, which results in alarms desensitization and ultimately affects patient care. Contributing to this problem are the International Electrotechnical Commission (IEC) 60601-1-8 alarms, a standardized set of melodic alarms used to convey information to clinicians in intensive care units. By design, IEC alarms employ flat amplitude (i.e., amplitude invariant) envelopes and are not reflective of naturally occurring sounds with percussive amplitude (i.e., decaying) envelopes. We present a series of three experiments evaluating the effect of amplitude envelope manipulation (i.e., incorporating percussive envelope) on memory and annoyance in IEC alarms synthesized using pure tones (experiment 1), complex tones (experiment 2) and assessing annoyance pre and post memory assessment (experiment 3). For the memory assessment, participants were assigned to learn either the flat alarms or percussive alarms. During the memory assessment, participants were informed of the alarm–referent pairings (study phase), practised identifying alarms (training phase), had a short break, and tested on their ability to identify alarms (evaluation phase). The annoyance assessment was a two alternative forced choice task where participants identified which alarm they perceived to be more annoying from a pair of alarms differing in either envelope-type or alarm-type. Across all experiments there was no difference in alarm learnability between those learning either flat or percussive alarms during the memory assessment. Annoyance assessments revealed that all participants chose the flat alarms to be more annoying than the percussive alarms, independent of the memory assessment condition. These results showcase the potential of using percussive alarms to reduce alarm annoyance without harming learnability, a cost-efficient manipulation. / Thesis / Master of Science (MSc) / Alarms in intensive care units are perceived as annoying, ultimately negatively affecting both clinicians and patients. These alarms are mandated by the International Electrotechnical Commission to have sustained or flat amplitude envelopes (i.e., referring to the change in loudness over time), which does not reflect naturally occurring stimuli that typically have decaying or percussive amplitude envelopes. The current experiments assessed the effect of percussive envelopes on alarm learnability and annoyance. We showed in a series of experiments that there is no difference in learning alarms with flat or percussive envelopes. However, we showed that alarms with percussive envelopes are perceived to be less annoying than alarms with flat envelopes. These results offer one potential solution to reduce alarm annoyance in intensive care units without harming the learnability of these alarms.