Alarm Fatigue and Missed Nursing Care Among Neonatal and Paediatric Intensive Care Nurses: A Cross-Sectional Study.

BACKGROUND

Intensive care units (ICUs) are high-technology environments where patient safety is monitored through various devices. However, the high frequency of alarms can lead to alarm fatigue, especially in neonatal and paediatric ICUs due to rapid physiological fluctuations. This condition may decrease nurses' attention and lead to missed nursing care.

AIMS: The primary aim of this study was to determine the levels of alarm fatigue and missed nursing care, along with the underlying reasons for missed care, among neonatal and paediatric intensive care nurses. The secondary aim was to examine the relationship between alarm fatigue levels and missed nursing care.

STUDY

DESIGN

This descriptive, cross-sectional correlational study was conducted in the neonatal and paediatric intensive care units of two public hospitals in Türkiye. Data were collected using self-administered instruments, including the Nurse Characteristics Form, Alarm Fatigue Questionnaire and MISSCARE Survey-Paediatric Version.

RESULTS

The sample consisted of 175 neonatal and paediatric intensive care nurses. The mean alarm fatigue score was 15.46 ± 5.88. Labour and communication resources factors were prominent reasons for missed nursing care. A positive and statistically significant relationship was found between alarm fatigue and the reasons for missed nursing care, including labour (r = 0.243, p = 0.001), communication (r = 0.208, p = 0.006) and material resource factors (r = 0.268, p < 0.001).

CONCLUSIONS

Effective alarm management strategies, adequate staffing and improved communication processes may help reduce missed nursing care and enhance patient safety in neonatal and paediatric intensive care units.

RELEVANCE TO CLINICAL PRACTICE: Reducing alarm fatigue in paediatric intensive care settings is essential. However, given the clinical vulnerability of paediatric patients, the life-saving nature of these alarms mandates the provision of in-service training on alarm management and the optimisation of patient-specific alarm settings. Furthermore, to enhance the quality of care and optimise patient safety, it is recommended that institutional resources be improved and effective inter-professional communication strategies be developed.