Intensive & critical care nursing · 2026
Levels and factors of healthcare workers' alarm fatigue in intensive care unit settings in Central China: A cross-sectional study of 20 hospitals.
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Liu Dongmei, Xiao Qi, Xu Qin, Wang Yixuan, Hu Hongjie, Song Yaqin, Jing Liang, Xiong Jie, Zhu Wei
Аннотация
OBJECTIVE: This study aimed to investigate the levels of alarm fatigue among ICU nurses in 20 hospitals in Hubei Province, China, using an ICU nurse-specific alarm fatigue measurement tool. Additionally, we reassessed the scale's reliability and validity among ICU physicians and explore personal and organizational factors associated with alarm fatigue in both groups.
METHODS: A descriptive cross-sectional study was conducted among ICU healthcare workers (nurses and physicians) from 20 hospitals in Hubei Province between April and May 2025. Data were collected via electronic questionnaires, including demographic information, the ICU Nurse Alarm Fatigue Questionnaire (ICU-NAFQ), the Chinese version of the NASA Task Load Index, and the Chinese version of the Maslach Burnout Inventory-General Survey. The ICU-NAFQ showed acceptable reliability among physicians (Cronbach's α = 0.714). Exploratory factor analysis confirmed structural stability. A total of 503 valid responses (382 nurses, 121 physicians) were analyzed using SPSS 26.0, with statistical methods including t-tests, ANOVA, correlation analyses, and multiple linear regression.
RESULTS: The mean alarm fatigue score among ICU nurses was 23.30 ± 6.08 (moderate severity, approaching high severity), with 42.9% classified as high-severity. ICU physicians scored significantly higher (25.46 ± 5.68, p < 0.05), with 58.7% in the high-severity category. In multiple linear regression, among nurses, alarm fatigue scores were independently associated with educational level, the presence of dedicated noise quality management personnel, and the burnout dimensions of emotional exhaustion and reduced personal accomplishment (all p < 0.05). Among physicians, alarm fatigue was associated with gender, educational level and reduced personal accomplishment (all p < 0.05).
CONCLUSION: Alarm fatigue is prevalent and severe among ICU physicians and nurses in China, with physicians at higher risk. Special attention should be directed toward ICU nurses with higher education levels, those working in units without dedicated personnel for noise quality management, and those scoring higher on the EE and RPA dimensions of burnout, as well as male physicians scoring higher on the RPA dimension of burnout. Our findings provide important guidance for future intervention.
IMPLICATIONS FOR CLINICAL PRACTICE: Healthcare institutions should establish routine monitoring systems for environmental factors and staff wellbeing to identify early signs of alarm fatigue and guide timely interventions. Standardized alarm management protocols and regular evidence-based training are essential to improve alarm response practices. Adoption of advanced alarm technologies may further reduce false alarms and enhance accuracy. Targeted support strategies should be implemented for high-risk healthcare professionals to mitigate burnout and optimize patient safety.
METHODS: A descriptive cross-sectional study was conducted among ICU healthcare workers (nurses and physicians) from 20 hospitals in Hubei Province between April and May 2025. Data were collected via electronic questionnaires, including demographic information, the ICU Nurse Alarm Fatigue Questionnaire (ICU-NAFQ), the Chinese version of the NASA Task Load Index, and the Chinese version of the Maslach Burnout Inventory-General Survey. The ICU-NAFQ showed acceptable reliability among physicians (Cronbach's α = 0.714). Exploratory factor analysis confirmed structural stability. A total of 503 valid responses (382 nurses, 121 physicians) were analyzed using SPSS 26.0, with statistical methods including t-tests, ANOVA, correlation analyses, and multiple linear regression.
RESULTS: The mean alarm fatigue score among ICU nurses was 23.30 ± 6.08 (moderate severity, approaching high severity), with 42.9% classified as high-severity. ICU physicians scored significantly higher (25.46 ± 5.68, p < 0.05), with 58.7% in the high-severity category. In multiple linear regression, among nurses, alarm fatigue scores were independently associated with educational level, the presence of dedicated noise quality management personnel, and the burnout dimensions of emotional exhaustion and reduced personal accomplishment (all p < 0.05). Among physicians, alarm fatigue was associated with gender, educational level and reduced personal accomplishment (all p < 0.05).
CONCLUSION: Alarm fatigue is prevalent and severe among ICU physicians and nurses in China, with physicians at higher risk. Special attention should be directed toward ICU nurses with higher education levels, those working in units without dedicated personnel for noise quality management, and those scoring higher on the EE and RPA dimensions of burnout, as well as male physicians scoring higher on the RPA dimension of burnout. Our findings provide important guidance for future intervention.
IMPLICATIONS FOR CLINICAL PRACTICE: Healthcare institutions should establish routine monitoring systems for environmental factors and staff wellbeing to identify early signs of alarm fatigue and guide timely interventions. Standardized alarm management protocols and regular evidence-based training are essential to improve alarm response practices. Adoption of advanced alarm technologies may further reduce false alarms and enhance accuracy. Targeted support strategies should be implemented for high-risk healthcare professionals to mitigate burnout and optimize patient safety.