Assignment: Enteral Feeding Pumps
Six labor nurses participated in 1 focus group at site B. Participants’ experience as nurses in their specialty varied based on clinical set- ting, with NICU nurse participants most experi- enced (mean, 19.9 years; range, 1-32 years), fol- lowed by labor nurses (mean, 10.2 years; range, 3-35 years), and adult ICU nurses (mean, 4 years; range, 2-7 years).
Types of alerts and alarms Nurses in each clinical setting reported alerts and alarms for medical devices specific to their specialty as well as routine vital sign monitor- ing. All reported use of monitors with alarms that measured physiologic parameters includ- ing oxygen saturation, respiratory rate, heart rate, and electrocardiography, IV pumps, and hospital-issued smartphones. Devices specific to the specialty included ventilators and enteral feeding pumps (ICU and NICU), infant warm- ers and infant security systems (labor and birth unit and NICU), bed and chair alarms (ICU), and EFM (labor and birth). Adult ICU nurses had interactions with the eICU. This list is not all inclusive, rather those devices mentioned by participants.
Themes There were many commonalities among re- sponses about clinical alerts and alarms of partic- ipants representing all 3 specialties. Nurses gen- erally shared the same concerns. Distinctions be- tween comments of nurses in each specialty were limited to specific devices used on their unit. Four underlying themes emerged: alarm fatigue, im- pact of alarms on patients and family, implica- tions for patient safety, and suggestions for im- provement. No differences were noted in labor nurses’ responses based on the EFM surveillance system vendor.
Alarm fatigue Nurses reported auditory and visual notifica- tions from multiple devices. There was consen- sus among participants that there were too many alarms in their clinical setting, and it was diffi- cult to maintain a real-time sense of those that were important to patient safety and those that were nonactionable or low priority.
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