Nursing Practice and Decision-Making Process in Response to Monitor Alarms among Critical Care Nurses

Persistent Link:
http://hdl.handle.net/10150/620966
Title:
Nursing Practice and Decision-Making Process in Response to Monitor Alarms among Critical Care Nurses
Author:
Schatz, Marilyn Rose
Issue Date:
2016
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
Background: Alarm interpretation and management are fundamental to managing critically ill patients. 1 There is little research as to the decision process nurses use to prioritize alarms or manage specific monitor parameters. Objective: The purpose of this study is to gain insight into the intricacy of the intensive care unit (ICU) nurses'critical decision process, using a human performance framework, when responding to monitor alarms. Method: Design: Descriptive design using semi-structured interview. Open-ended questions were developed based on the critical decision method (CDM) to explore ICU nurses' critical decision making process related to monitor alarms. Sixteen ICU nurses at a community hospital were interviewed to elicit perceptions and thought processes related to monitor alarms. Results: Responses to monitor alarms were affected by nursing experience, tones of the alarm, nurses' knowledge of the patient's condition as well as immediate visualization of patient to judge the urgency of an alarm. Both advanced beginner and expert nurses had similar initial response to monitor alarms; however, expert nurses added depth to their immediate assessment process by using previous experiences, intuition, and clinical expertise. Advanced beginner nurses frequently look to expert nurses for advice, guidance, and examples of clinical expertise. The majority of nurses had little or no formal training on the cardiac monitors used by that facility and all felt it would be beneficial in monitor alarm management. Conclusion: Understanding the decision-making process used by nurses can guide the development of policies and learning experiences that are crucial clinical support for alarm management.
Type:
text; Electronic Dissertation
Keywords:
Cognitive Task Analysis; Critical Decision Method; Decision-Making; Monitor Alarms; Nursing; Alarm Fatigue
Degree Name:
D.N.P.
Degree Level:
doctoral
Degree Program:
Graduate College; Nursing
Degree Grantor:
University of Arizona
Advisor:
Wung, Shu-Fen

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.titleNursing Practice and Decision-Making Process in Response to Monitor Alarms among Critical Care Nursesen_US
dc.creatorSchatz, Marilyn Roseen
dc.contributor.authorSchatz, Marilyn Roseen
dc.date.issued2016-
dc.publisherThe University of Arizona.en
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en
dc.description.abstractBackground: Alarm interpretation and management are fundamental to managing critically ill patients. 1 There is little research as to the decision process nurses use to prioritize alarms or manage specific monitor parameters. Objective: The purpose of this study is to gain insight into the intricacy of the intensive care unit (ICU) nurses'critical decision process, using a human performance framework, when responding to monitor alarms. Method: Design: Descriptive design using semi-structured interview. Open-ended questions were developed based on the critical decision method (CDM) to explore ICU nurses' critical decision making process related to monitor alarms. Sixteen ICU nurses at a community hospital were interviewed to elicit perceptions and thought processes related to monitor alarms. Results: Responses to monitor alarms were affected by nursing experience, tones of the alarm, nurses' knowledge of the patient's condition as well as immediate visualization of patient to judge the urgency of an alarm. Both advanced beginner and expert nurses had similar initial response to monitor alarms; however, expert nurses added depth to their immediate assessment process by using previous experiences, intuition, and clinical expertise. Advanced beginner nurses frequently look to expert nurses for advice, guidance, and examples of clinical expertise. The majority of nurses had little or no formal training on the cardiac monitors used by that facility and all felt it would be beneficial in monitor alarm management. Conclusion: Understanding the decision-making process used by nurses can guide the development of policies and learning experiences that are crucial clinical support for alarm management.en
dc.typetexten
dc.typeElectronic Dissertationen
dc.subjectCognitive Task Analysisen
dc.subjectCritical Decision Methoden
dc.subjectDecision-Makingen
dc.subjectMonitor Alarmsen
dc.subjectNursingen
dc.subjectAlarm Fatigueen
thesis.degree.nameD.N.P.en
thesis.degree.leveldoctoralen
thesis.degree.disciplineGraduate Collegeen
thesis.degree.disciplineNursingen
thesis.degree.grantorUniversity of Arizonaen
dc.contributor.advisorWung, Shu-Fenen
dc.contributor.committeememberWung, Shu-Fenen
dc.contributor.committeememberMerkle, Carrie J.en
dc.contributor.committeememberRigney, Ted S.en
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