Evaluating the Alarm Fatigue and its Associated Factors among Clinicians in Critical Care Units

The Alarm Fatigue (AF) occurs when clinicians are exposed to a large number of false alarms which can cause alarm desensitization. AF is a well-recognized patient safety concern in intensive care settings. This study aims to evaluate the alarm fatigue in clinicians along with its associated factors in critical care settings using a valid and reliable instrument. During 2020, a cross-sectional study was conducted among clinicians working in Critical care units in Lebanon and enrolled 337 participants via self-administered electronic questionnaire. The survey included questions on socio-demographic characteristics, health status, staff recognition of alarms and alarm management, and Alarm Fatigue questionnaire. The translation and cultural adaptation of the Alarm Fatigue questionnaire in Arabic followed a standardized protocol.  The mean age of participants was 30.79 (SD=7.26; median=29) years, 61.4% were women. 77.2% were nursing staff and 22.8% were physicians. 78.8% worked in private hospitals.  41.3% of staff were from neonatal and pediatric intensive care units. 58.8% of clinicians find that more than 50% of alarms were irrelevant, and 69.4% deactivate and silence the alarm when annoyed. The Alarm Fatigue questionnaire has good reliability and validity. The Cronbach alpha was 0.69 which establishes good reliability for group comparison. AF in physicians (OR=2.25; 95%CI=-0.01-4.50, p=0.05) and Registered Nurses (OR=2.64; 95%CI=-0.52-4.75, p=0.02) was higher than in nurses and head nurses; AF was more frequent in ICUs units (OR=2.1; 95%CI=0.05-4.18, p=0.04) compared to other critical care units.  The AF was higher for the clinicians that deactivate and silence the alarm when annoyed compared to other subgroup (OR=4.14, 95%CI=2.75–5.53, p<0.001).  The AF was 3.14 times frequent for the staff who reported stress (p<0.001). Non-actionable alarms occurred frequently and associated to alarm fatigue.  Physicians score slightly higher alarm fatigue than nurses. The Arabic Alarm Fatigue questionnaire has a good psychometric properties and suitable to evaluate the AF in Lebanon.  Multidisciplinary approaches can be established to minimize the incidence of AF using a valid and reliable instrument.