Improving nurses' alarm-management performance with a behavioral reminder.

چکیده اصلی

OBJECTIVE: To determine whether adding a behavioral reminder to the CEASE Bundle improves alarm-management performance and reduces alarm fatigue among intensive care nurses. METHOD: A controlled quasi-experimental pretest-posttest study was conducted with 115 nurses from adult intensive care units. Sixty-two nurses participated in the intervention group and 53 in the control group. Data were obtained with the Nurse Identification Form, CEASE Bundle, Alarm Type and Management Form, "Remind Me" Monitor Alarm Control Tool, and Alarm Fatigue Scale. CEASE provided the basis for observation and evaluation in both groups. Remind Me was used only by the intervention group for 15 days. RESULTS: Compared with the control group, nurses in the intervention group demonstrated more favorable alarm-management behaviors and Alarm Fatigue Scale scores. Alarm response times decreased by approximately 15%-23% across alarm types, and the mean Alarm Fatigue Scale score in the intervention group increased from 68.67 ± 7.52 to 74.92 ± 4.22. Significant improvements were observed in several CEASE components, including communication, electrode and pulse oximeter care, adjustment of alarm limits, cancellation of unnecessary parameters, and identification of educational needs. In the multivariable analysis, exposure to the Remind Me intervention was independently associated with better alarm-management performance. CONCLUSION: Integrating the Remind Me behavioral reminder into routine monitoring practices was associated with more favorable alarm-management behaviors, shorter alarm response times, and reduced alarm fatigue among intensive care nurses. These findings suggest that low-cost reminder-based strategies may strengthen evidence-based alarm-management practices. CLINICAL TRIAL REGISTRATION: NCT06403397 (URL: https://clinicaltrials.gov/study/NCT06403397).

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