According to The Joint Commission (TJC), 98 unexpected and unacceptable events related to alarm fatigue were reported in United States hospitals between January 2009 and June 2012. There were 80 deaths, 13 permanent loss of function, and 5 extended care stays that occurred during this time period. The problem identified in this quality improvement (QI) initiative was the TJC report that nursing staff in the US was experiencing alarm fatigue due to the overstimulation of senses from continuous beeping from alarms on the unit. Framed within the Iowa model of evidence-based practice to promote quality care, the purpose of the project was to develop a patient care alarm fatigue initiative as mandated by TJC including a policy and procedure for managing alarm fatigue, a curriculum plan for educating the nursing staff on alarm fatigue, and a survey on nurse attitudes toward alarm fatigue to be administered at the beginning of the education. The developed policy and procedure was approved by the committee with the recommendation to revise the policy to involve all ancillary staff in direct contact with clinical alarms. The curriculum objectives were evaluated by 2 content experts using a 4 item met/not met response format. Findings showed that all objectives were met. The content of the nurse survey was reviewed by the experts using a 3 item Likert scale and all the items were deemed relevant. Finally, team members (n = 9) completed a summative evaluation of the project using an 8 item, 5-option Likert scale. All were in agreement that the project met its intent. The implementation of this project after graduation has the potential to bring about social change by increasing patient safety, patient well being and reducing healthcare costs.

There is limited clinical research on the effectiveness of alarm management strategies and nursing behaviors related to alarms in clinical settings. As many as 76% of physiological monitor alarms are overlooked as clinically insignificant by nursing staff. Excessive alarms may impact patient outcomes and cause cognitive overload for nurses that can result in medical errors and missed patient resuscitations. The purpose of this systematic review was to rate alarm management studies on level of evidence for interventions, nursing responses to alarms, and impact on alarm fatigue behavior. The nursing role effectiveness model guided this project. Twenty-seven studies were reviewed to analyze outcome effectiveness by addressing structure, process, and outcomes related to how the roles of the nurse affect nurse-sensitive patient outcomes. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and the Cochrane guidelines guided study selection and analysis. A second reviewer collaborated on the search strategy and provided an independent review of the identified literature. The effectiveness of alarm management was difficult to determine because most studies were descriptive, cohort, or nonrandomized trials. Review findings did not support a relationship between the amount of alarms and increased alarm fatigue behaviors. Findings indicated that nurses' attitudes and alarm fatigue behaviors are present globally and have not significantly altered since reduction strategies were implemented. The findings may impact social change by decreasing nurses' stress levels related to cognitive workloads, improving patient outcomes, and supporting increased levels of nurses' workforce satisfaction.