Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-26T04:18:49.679Z Has data issue: false hasContentIssue false

Alarm Compliance in Healthcare: Design Considerations for Actionable Alarms (In Intensive Care Units)

Published online by Cambridge University Press:  26 July 2019

Rosana Sanz-Segura*
Affiliation:
School of Engineering and Architecture. University of Zaragoza;
Eduardo Manchado Pérez
Affiliation:
School of Engineering and Architecture. University of Zaragoza;
Elif Özcan
Affiliation:
Faculty of Industrial Design Engineering Delft University of Technology. Department of Intensive Care Erasmus Medical Centre
*
Contact: Sanz-Segura, Rosana University of Zaragoza, Design and Manufacturing Engineering, Spain, rsanz@unizar.es

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Intensive care units are technologically advanced environments that are designed to safeguard the patient while their vitals are stabilized for further treatment. Audible and visual alarms are part of the healthcare ecology. However, these alarms are so many that clinicians suffer from a syndrome called ‘alarm fatigue’ and often do not comply with the task alarm is conveying. Measuring compliance with rules in the workspace and determining the success of a system belongs to the field of ergonomics and is based on data collected through task observations and scoring. In this paper, we will explore compliance with critical alarms by not only from their potential success or failure perspective but also from the perspectives of the clinician capacity, needs, and motivations to comply with alarms in critical environments. We will finally, reflect on further possible design strategies to increase compliance in critical care that are beyond following rules per se but through intrinsic motivation.

Type
Article
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
© The Author(s) 2019

References

Baldwin, C. L. and Lewis, B. A. (2014), “Perceived urgency mapping across modalities within a driving context”, Applied Ergonomics, Vol. 45 No. 5, pp. 12701277. https://doi.org/10.1016/j.apergo.2013.05.002Google Scholar
De Geest, S. and Sabaté, E. (2003), “Adherence to long-term therapies: Evidence for action”, European Journal of Cardiovascular Nursing, Vol. 2 No. 4, pp. 323323. http://doi.org/10.1016/s1474-5151(03)00091-4.Google Scholar
Edworthy, J. (2013), J Am Med Inform Assoc, Vol. 20, pp. 584589. http://doi.org/10.1136/amiajnl-2012-001061Google Scholar
Fogg, B. J. (2002), “Persuasive technology: using computers to change what we think and do”, Ubiquity, Vol. 5. https://doi.org/10.1145/764008.763957Google Scholar
Fogg, B. J. (2009), “Creating persuasive technologies”, Proceedings of the 4th International Conference on Persuasive Technology - Persuasive'09. http://doi.org/10.1145/1541948.1542005.Google Scholar
Gibson, J. (1979), The Ecological Approach to Human Perception. https://doi.org/10.1002/bs.3830260313Google Scholar
Graham, R. (1999), “Use of auditory icons as emergency warnings: evaluation within a vehicle collision avoidance application”, Ergonomics, Vol. 42 No. 9, pp. 12331248.Google Scholar
Hancock, H. C. and Easen, P. R. (2006), “The decision-making processes of nurses when extubating patients following cardiac surgery: an ethnographic study”, International Journal of Nursing Studies, Vol. 43 No. 6, pp. 693705. https://doi.org/10.1016/j.ijnurstu.2005.09.003Google Scholar
Hancock, P. A. and Szalma, J. L. (Eds.) (2008), Performance under Stress. Ashgate Publishing, Ltd.Google Scholar
Hancock, P. A. and Warm, J.S. (1989), “A dynamic model of stress and sustained attention”, Human Factors, Vol. 31 No. 5, pp. 519537. https://doi.org/10.1177/001872088903100503Google Scholar
Heydra, C. G., Jansen, R. J. and Van Egmond, R. (2014), “Auditory signal design for automatic number plate recognition system”, In Creating the Difference: Proceedings of the Chi Sparks 2014 Conference, The Hague The Netherlands, 13 April 2014. The Hague University of Applied Sciences.Google Scholar
Humaidi, N. and Balakrishnan, V. (2015), “Leadership styles and information security compliance behavior: The mediator effect of information security awareness”, International Journal of Information and Education Technology, Vol. 5 No. 4, p. 311. https://doi.org/10.7763/ijiet.2015.v5.522Google Scholar
Kellermann, K. (1992), “Communication: Inherently strategic and primarily automatic”, Communications Monographs, Vol. 59 No. 3, pp. 288300. https://doi.org/10.1080/03637759209376270Google Scholar
Kristensen, M., Edworthy, J. and Özcan, E. (2017). “In search of acoustical signs of alarm fatigue”, Sound Effects, pp. 88104.Google Scholar
Joint Commission. (2013), “Medical device alarm safety in hospitals”, Sentinel Event Alert, No. 50, p. 1.Google Scholar
Lazarus, R. S. (1990), “Theory-based stress measurement”, Psychological Inquiry, Vol. 1 No. 1, pp. 313. https://doi.org/10.1207/s15327965pli0101_1Google Scholar
Manzey, D., Gérard, N. and Wiczorek, R. (2014), “Decision-making and response strategies in interaction with alarms: the impact of alarm reliability, availability of alarm validity information and workload”, Ergonomics, Vol. 57 No. 12, pp. 18331855. https://doi.org/10.1080/00140139.2014.957732Google Scholar
Matthews, J. et al. (2016), “Persuasive technology in mobile applications promoting physical activity: a systematic review”, Journal of Medical Systems, Vol. 40 No. 3. http://doi.org/10.1007/s10916-015-0425-x.Google Scholar
Mechanic, D. (1978), “Effects of psychological distress on perceptions of physical health and use of medical and psychiatric facilities”, Journal of Human Stress, Vol. 4 No. 4, pp. 2632. https://doi.org/10.1080/0097840x.1978.10545983Google Scholar
Nakajima, T. and Lehdonvirta, V. (2011), “Designing motivation using persuasive ambient mirrors”, Personal and Ubiquitous Computing, Vol. 17 No. 1, pp. 107126. http://doi.org/10.1007/s00779-011-0469-y.Google Scholar
International Electrotechnical Commission. 2006 “Medical electrical equipment, part 1–8: General requirements, tests and guidance for alarm systems in medical electrical equipment and medical electrical systems”. 2005, Geneva. IEC 60601-1-8. International Electrotechnical Commission, Geneva.Google Scholar
Oinas-Kukkonen, H. (2009), “Persuasive systems design: key issues, process model, and system features”, Communications of the Association for Information Systems, Vol. 24. http://doi.org/10.17705/1cais.02428.Google Scholar
Orji, R. (2016), “Preface to the International Workshop on Personalization in Persuasive Technology: Research Challenges and Opportunities Strategies”. In PPT@ PERSUASIVE (pp. 15).Google Scholar
Özcan, E. (2018), Critical Alarms Lab. [online] Delft University of Technology. Available at: (https://delftdesignlabs.org/criticalalarmslab/) (13th December 2018).Google Scholar
Patterson, R. D. (1982), “Guidelines for auditory warning systems on civil aircraft”, Civil Aviation Authority.Google Scholar
Phansalkar, S., Zachariah, M., Seidling, H. M., Mendes, C., Volk, L. and Bates, D. W. (2014), “Evaluation of medication alerts in electronic health records for compliance with human factors principles”, Journal of the American Medical Informatics Association, Vol. 21 No. e2, pp. e332e340. http://doi.org/10.1136/amiajnl-2013-002279.Google Scholar
PowerDMS. (December, 2017), Definition of Compliance in Healthcare. [online]. Available at: (https://www.powerdms.com/blog/definition-compliance-healthcare/) (13th December 2018).Google Scholar
Prochaska, J. O. and Velicer, W. F. (1997), “The transtheoretical model of health behavior change”, American Journal of Health Promotion, Vol. 12 No. 1, pp. 3848. http://doi.org/10.4278/0890-1171-12.1.38.Google Scholar
Scherer, K. R. (1999), Appraisal Theory. Handbook of cognition and emotion, pp. 637663. https://doi.org/10.1002/0470013494.ch30Google Scholar
Shannon, C. E. and Weaver, W. (1949), The Mathematical Theory of Communication, University of Illinois Press, Urbana, IL.Google Scholar
Sorkin, R. D. (1988), “Why are people turning off our alarms?”, The Journal of the Acoustical Society of America, Vol. 84 No. 3, pp. 11071108. https://doi.org/10.1121/1.397232Google Scholar
Teixeira De Sousa, B., Donati, A., Özcan, E., van Egmond, R., Edworthy, J., Jansen, R. … and Voumard, Y. (2016), “Designing and deploying meaningful audio alarms for control systems”. In 14th International Conference on Space Operations (p. 2616). https://doi.org/10.2514/6.2016-2616Google Scholar
Sowan, A. K., Tarriela, A. F., Gomez, T. M., Reed, C. C. and Rapp, K. M. (2015), “Nurses’ perceptions and practices toward clinical alarms in a transplant cardiac intensive care unit: Exploring key issues leading to alarm fatigue”, JMIR Human Factors, Vol. 2 No. 1. https://doi.org/10.2196/humanfactors.4196Google Scholar