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HealthJuly 06, 2021

Could alarm fatigue actually start in nursing school?

By: Sarah Handzel, BSN, RN
Clinical alarms are obviously vital to patient care in acute settings. From medication pumps to monitors, alarms alert nursing staff to changes in a patient’s condition.

But some research indicates that 72–99% of all alarms are false, leading to a condition among nursing staff known as alarm fatigue.

Alarm fatigue may be defined as a type of sensory overload occurring when nurses are exposed to an excessive number of alarms. This may ultimately result in nurses becoming desensitized to alarm sounds which may, in turn, lead to an increased rate of missed alarms.

But does alarm fatigue only begin after a nurse is licensed and practicing in an acute care facility? Or does it begin sooner? A recent study in Nursing2021 tested the theory that alarm fatigue may actually begin in nursing school before a new nurse even enters the workforce.

Alarm fatigue study details and methods

Weeks, et al developed their study with two purposes:

  • To explore whether alarm fatigue develops in nursing students between the first and last clinical exposures in hospital settings
  • To determine if a history of healthcare work increased alarm fatigue

To determine the answers to these questions, the study authors implemented a longitudinal quantitative survey among BSNs from a second semester cohort in the southeaster United States. The survey was administered before and after each clinical exposure over a period of 18 months.

Students completed the three-part survey by answering questions about their demographics, previous healthcare employment, and areas of interest in healthcare. Additionally, the study authors used a five-item Likert survey to further examine individual sensitivities to common alarm noises in acute care settings. The five-item survey included questions like:

  • How sensitive do you feel when you hear a call bell ring?
  • How sensitive do you feel when you hear a fall and safety alarm ring?
  • How sensitive do you feel when you hear an I.V. infusion pump ring?

The alarm types were chosen based on a review of literature that determined which safety alarms were most commonly ignored. Understanding that some students may not have exposure to certain alarms, Weeks et al created a self-reporting tool. This tool addressed alarm sensitivity and recognition among novice nursing students.

Alarm fatigue among nursing students

The results of the study showed a decrease in sensitivity to I.V. infusion pump alarms, especially the longer the student was in the program. The study authors suggest that more clinical experience with alarms may actually teach nursing students to ignore them. However, students did report greater sensitivity to fall and safety alarms. This may be because these topics are emphasized in nursing school.

The study also demonstrated that increased exposure to and experience with alarms did not provide students with a strong familiarity with their associated patient safety concerns. Consequently, the authors speculate that nursing students could actually affect patient safety negatively by ignoring or failing to respond to patient-care alarms.

Weeks et al acknowledge that this study was limited to a small sample size. However, since alarm fatigue is a well-documented problem among nurses, the study may help nurse educators develop strategies to improve awareness of alarm fatigue among nursing students.

Sarah Handzel, BSN, RN
Freelance Health and Medical Content Writer, Wolters Kluwer Health
Sarah has over nine years’ experience in various clinical areas, including surgery, endocrinology, family practice, and pharmaceuticals. She began writing professionally in 2016 as a way to use her medical knowledge beyond the bedside to help educate and inform healthcare consumers and providers.
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