Nurses’ reactions to alarms in a neonatal intensive care unit

Neonatal intensive care units (NICUs), like other intensive care units, are intended to provide immediate responses to any change in the patient’s condition. Patient-monitoring alarms and alarms from other medical equipment are very common in these units, and most alarms have no clinical significance. This study addresses the question of how alarms affect nurses’ actions by measuring the occurrence of alarms from different causes in a NICU, recording the nurses’ reactions, and analyzing the relationship between the alarms and the actions. The results show that nurses often do not respond directly to alarms, but, rather, use them as additional sources of information in their ongoing flow of actions. The probabilities for their responding to an alarm depend on the causes of the alarm, its duration, and the characteristics of the patient. These findings support the view that experienced nurses dynamically adjust their activities according to the information they receive from alarm systems and other sources, and that they combine their reactive actions with the periodic performance of routine tasks.