집중치료실 간호사에 대한 환자감시장치 경보음 관리 교육의 효과

Abstract

The purpose of this study was to examine the effects of patient monitor alarm management education on nurses' performances of alarm management, frequency of false alarms, and alarm fatigue. The research design used in this study was a quasi-experimental, one-group pretest-posttest design. The study was conducted from Jul. 30, 2018, to Aug. 26, 2018, with 19 medical intensive care unit (ICU) nurses and on 12 patient monitors of a university hospital in J city, South Korea. The alarm management education consisted of three sections: 'alarm hazard,' 'alarm management,' and 'questions and answers'. The alarm management guidance developed by the researcher was posted within the ICU so that the subjects could refer to the guidance for the alarm management-related nursing intervention at any time. An alarm manager was also appointed during each shift to monitor the subjects' alarm management-related nursing interventions. The assessment scales included: the level of the performance of alarm management of the nurses, the frequency of false alarms from patient monitors, and the level of alarm fatigue. The collected data were analyzed using the SPSS WIN 18.0 program. The differences in performance of alarm management and alarm fatigue depending on the general and job-related characteristics of the subjects were analyzed using the independent t-test, Mann-Whitney U test, and the Kruskal Wallis test. The hypothesis test was evaluated using the paired t-test and the Wilcoxon signed ranks test. The significance level was set for .05. The results are as follows. 1) The level of performance of alarm management of the nurses showed a statistically significant increase after education. (t=-5.68, p=.001) 2) The frequency of false alarms from patient monitors managed by the nurses showed a statistically significant decrease after education. (Z=-4.42, p<.001). 2-1) The frequency of valid alarms from patient monitors managed by the nurses showed no statistically significant difference after education. (Z=-0.16, p=.870). 4) The level of alarm fatigue of the nurses showed a statistically significant decrease after education. (t=2.71, p=0.14) As shown above, patient monitor alarm management education proved to have beneficial effects on the level of performance of alarm management and alarm fatigue of the nurses, and the frequency of false alarms from patient monitors. Therefore, It is expected that ICU nurses will actively use the nursing intervention model applied in the research for the purpose of improving performance of alarm management and preventing patient safety-related hazards due to false alarm from patient monitors. Based on present study, it can be suggested that follow-up researches regarding the effects of alarm management education on the actual safety levels of patients and the safety performance levels and productivity of nurses are needed.