临床护士医疗设备警报疲劳预防与管理的最佳证据总结

陈少如; 张俊峰; 支慧; 张惠怡; 吴苏; 姜茹鑫; 张红梅

doi:10.16460/j.issn2097-6569.2025.10.055

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护理学报 ›› 2025, Vol. 32 ›› Issue (10) : 55-60. DOI: 10.16460/j.issn2097-6569.2025.10.055

循证护理

临床护士医疗设备警报疲劳预防与管理的最佳证据总结

陈少如¹, 张俊峰², 支慧¹, 张惠怡¹, 吴苏¹, 姜茹鑫¹, 张红梅¹

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摘要

目的检索临床护士医疗设备警报疲劳预防与管理的最佳证据并进行汇总,为警报疲劳的预防管理决策提供依据。方法检索与临床护士警报疲劳管理与预防主题相关的的国内外指南网站、UpToDate、PubMed、CINAHL、Embase、Web of Science、维普、知网、万方以及专业协会网站。检索截止至2025年1月10日,由2名经过循证培训的人员进行质量评价与结果提取。结果共纳入25篇文献,包括4篇指南、1篇专家共识、1篇国家标准、3篇证据总结、14篇系统评价、2篇随机对照研究。汇总了34条证据,包括环境与人员准备、多学科合作、界定警报的阈值范围和优先级、定期评估反馈、降低误报警发生率、教育和培训、使用智能技术7个方面。结论本文对临床护士警报疲劳预防与管理的最佳证据进行了总结,为护士的临床决策提供了循证依据,有助于降低其警报疲劳,提升管理质量与效率。

关键词

警报疲劳 / 预防 / 管理 / 循证护理学

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陈少如, 张俊峰, 支慧, 张惠怡, 吴苏, 姜茹鑫, 张红梅. 临床护士医疗设备警报疲劳预防与管理的最佳证据总结[J]. 护理学报. 2025, 32(10): 55-60 https://doi.org/10.16460/j.issn2097-6569.2025.10.055

中图分类号： R192.6

参考文献

[1] Torabizadeh C, Yousefinya A, Zand F, et al.A nurses’ alarm fatigue questionnaire: development and psychometric properties[J]. J Clin Monit Comput, 2017, 31(6): 1305-1312. DOI:10.1007/s10877-016-9958-x.
[2] Lewandowska K, Weisbrot M, Cieloszyk A, et al.Impact of alarm fatigue on the work of nurses in an intensive care environment-a systematic review[J]. Int J Environ Res Public Health, 2020, 17(22): 1-14. DOI:10.3390/ijerph17228409.
[3] NICE. Early sense for heart and respiratory monitoring and predicting patient deterioration[EB/OL].(2016-01-22). https://www.nice.org.uk/advice/mib49.
[4] Anderson HR, Borgen AC, Christnacht R, et al.Stats on the desats: alarm fatigue and the implications for patient safety[J]. BMJ Open Qual, 2023, 12(3):1-3. DOI:10.1136/bmjoq-2023-002262.
[5] Dee SA, Tucciarone J, Plotkin G, et al.Determining the impact of an alarm management program on alarm fatigue among icu and telemetry rns: an evidence-based research project[J]. SAGE Open Nurs, 2022(8):1-13. DOI:10.1177/23779608221098713.
[6] Nyarko BA, Nie H, Yin Z, et al.The effect of educational interventions in managing nurses’ alarm fatigue: an integrative review[J]. J Clin Nurs, 2023, 32(13-14):2985-2997. DOI:10.1111/jocn.16479.
[7] Yue L, Plummer V, Cross W.The effectiveness of nurse education and training for clinical alarm response and management: a systematic review[J]. J Clin Nurs, 2017, 26(17-18): 2511-2526. DOI:10.1111/jocn.13605.
[8] Kane-Gill SL, O’Connor MF, Rothschild JM, et al. Technologic distractions (part 1): summary of approaches to manage alert quantity with intent to reduce alert fatigue and suggestions for alert fatigue metrics[J]. Crit Care Med, 2017, 45(9): 1481-1488. DOI:10.1097/CCM.0000000000002580.
[9] Emergency Care Research Institute.The alarm safety workbook[EB/OL]. (2014-10-07). https ://www.ecri.org/alarm-safety-handbook.
[10] 何静,罗霞,佘兮,等. 基于系统管理理论的多功能心电监护仪警报管理实践[J]. 护理学报, 2019, 26(1): 25-27. DOI:10.16460/j.issn1008-9969.2019.01.025.
[11] 米娇,谭煜炜,唐小燕,等. 负性情绪在ICU护士心理负荷与报警疲劳的中介效应[J]. 护理学报, 2024, 31(3): 68-72.DOI:10.16460/j.issn1008-9969.2024.03.068.
[12] 朱政,胡雁,邢唯杰,等. 不同类型循证问题的构成[J]. 护士进修杂志, 2017, 32(21): 1991-1994.DOI:10.16821/j.cnki.hsjx.2017.21.025.
[13] Brouwers MC, Kho ME, Browman GP, et al.AGREE II: advancing guideline development, reporting and evaluation in health care[J]. CMAJ, 2010, 182(18): E839-842. DOI:10.1503/cmaj.090449.
[14] The Joanna Briggs Institute. Joanna Briggs Institute reviewers’manual: 2016 edition[M]. Australia: The Joanna Briggs Institute, 2016.
[15] 顾莺,张慧文,周英凤,等. JBI循证卫生保健中心关于不同类型研究的质量评价工具——系统评价的方法学质量评价[J]. 护士进修杂志, 2018, 33(8):701-703. DOI:10.16821/j.cnki.hsjx.2018.08.008.
[16] 周英凤,顾莺,胡雁,等. JBI循证卫生保健中心关于不同类型研究的质量评价工具——干预性研究的质量评价[J]. 护士进修杂志, 2018, 33(1): 24-26.DOI:10.16821/j.cnki.hsjx.2018.01.007.
[17] 陈耀龙,李幼平,杜亮,等. 医学研究中证据分级和推荐强度的演进[J].中国循证医学杂志, 2008, 8(2): 127-133.DOI:10.3969/j.issn.1672-2531.2008.02.012.
[18] 王春青,胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015(11): 964-967. DOI:1002-6975(2015)11-0964-04.
[19] 吴秀强,杨珍,谢志勤,等. 护士道德困境干预的最佳证据总结[J]. 护理学报, 2023, 30(1):47-52.DOI:10.16460/j.issn1008-9969.2023.01.047.
[20] The Joint Commission. National patient safety goals effective January2024 for the critical access hospital program [EB/OL]. (2023-10-04). https://www.jointcommission.org/standards/national-patient-safety-goals/.
[21] 岳丽青,李幸,刘鹏,等.多参数监护仪临床警报管理实践指南(2020版)简版[J]. 中国护理管理, 2021, 21(5): 758-765.DOI:10.3969/j.issn.1672-1756.2021.05.025.
[22] Sandau KE, Funk M, Auerbach A, et al.Update to practice standards for electrocardiographic monitoring in hospital settings: a scientific statement from the American Heart Association[J]. Circulation, 2017, 136(19): e273-e344. DOI:10.1161/CIR.0000000000000527.
[23] Stacy J, Susan S, Halley R.Managing alarms in acute care across the life span: electrocardiography and pulse oximetry[J]. Crit Care Nurse, 2018, 38(2): e16-e20. DOI:10.4037/ccn2018468.
[24] Le Roux P, Menon DK, Citerio G, et al.Consensus summary statement of the international multidisciplinary consensus conference on multimodality monitoring in neurocritical care: a statement for healthcare professionals from the neurocritical care society and the european society of intensive care medicine[J].Neurocrit Care, 2014, 21(Suppl 2): S1-26. DOI:10.1007/s12028-014-0041-5.
[25] 国家卫生健康委员会. 麻醉机安全管理[EB/OL]. (2020-05-01). http://www.nhc.gov.cn/wjw/s9495/202003/8343429db2a84c73b14fefaa43554511/files/a19cfde0f92d410882e53bf586e0e5f2.pdf.
[26] 张奕,陈香萍,邵桑,等. 床旁心电监护仪报警管理的最佳证据总结[J]. 中华护理杂志, 2021, 56(3): 445-451.DOI:10.3761/j.issn.0254-1769.2021.03.023.
[27] 李婷,胡慧玲,吴雪. ICU多参数心电监护仪阈值设置证据总结[J]. 中华危重病急救医学, 2023, 35(6): 643-650.DOI:10.3760/cma.j.cn121430-20230228-00121.
[28] 仇露露,张洪涛,万薇薇,等. ICU患者呼吸机警报管理的最佳证据总结[J]. 中华护理杂志, 2023, 58(23): 2864-2872.DOI:10.3761/j.issn.0254-1769.2023.23.007.
[29] Chromik J, Klopfenstein SAI, Pfitzner B, et al.Computational approaches to alleviate alarm fatigue in intensive care medicine: a systematic literature review[J]. Front Digit Health, 2022(4): 1-15. DOI:10.3389/fdgth.2022.843747.
[30] Winters BD, Cvach MM, Bonafide CP, et al.Technological distractions (part 2): a summary of approaches to manage clinical alarms with intent to reduce alarm fatigue[J]. Crit Care Med,2018,46(1):130-137. DOI:10.1097/CCM.0000000000002803.
[31] Sun L, Joshi M, Khan SN, et al.Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: a systematic review and Meta-analysis[J]. J R Soc Med, 2020, 113(6):217-224. DOI:10.1177/0141076820925436.
[32] Sowan AK, Staggers N, Reed CC, et al.State of science in alarm system safety: implications for researchers, vendors, and clinical leaders[J]. Biomed Instrum Technol, 2022, 56(1): 19-28. DOI:10.2345/0899-8205-56.1.19.
[33] Dinis MM, Rabiais CM.Factors that interfere with the response of nurses in the monitoring of clinical alarms[J]. Rev Bras Enferm, 2017, 70(1):172-179.DOI:10.1590/0034-7167-2015-0092.
[34] Scott JB, De Vaux L, Dills C, et al.Mechanical ventilation alarms and alarm fatigue[J]. Respir Care, 2019, 64(10): 1308-1313. DOI:10.4187/respcare.06878.
[35] Cvach M.Monitor alarm fatigue: an integrative review[J]. Biomed Instrum Technol, 2012, 46(4): 268-277. DOI:10.2345/0899-8205-46.4.268.
[36] 张斯齐,李梦玲,秦月兰,等. 护士临床警报应对影响因素的系统综述[J]. 中华现代护理杂志, 2021, 27(15): 2020-2026.DOI:10.3760/cma.j.cn115682-20201019-05808.
[37] Paine CW, Goel VV, Ely E, et al.Systematic review of physiologic monitor alarm characteristics and pragmatic interventions to reduce alarm frequency[J]. J Hosp Med, 2016, 11(2): 136-144. DOI:10.1002/jhm.2520.
[38] Bi J, Yin X, Li H, et al.Effects of monitor alarm management training on nurses’ alarm fatigue: a randomised controlled trial[J]. J Clin Nurs, 2020, 29(21-22): 4203-4216. DOI:10.1111/jocn.15452.
[39] Winters BD, Slota JM, Bilimoria KY.Safety culture as a patient safety practice for alarm fatigue[J]. JAMA, 2021, 326(12): 1207-1208. DOI:10.1001/jama.2021.8316.
[40] 薛燕,仲骏,郑吉莉. 多学科团队在降低心脏外科ICU护士监护仪报警疲劳中的应用[J]. 护理管理杂志, 2018, 18(8): 601-604.DOI:10.3969/j.issn.1671-315x.2018.08.016.
[41] ECRI. Reducing the noise from alerts, alarms,notifications[EB/OL]. (2020-07-08). https://blog.ecri.org/reducing-noise-alerts-alarms-notifications.
[42] Albert NM, Murray T, Bena JF, et al.Differences in alarm events between disposable and reusable electrocardiography lead wires[J]. Am J Crit Care, 2015, 24(1): 67-73. DOI:10.4037/ajcc2015663.
[43] Cvach M, Biggs M, Rothwell KJ, et al.Daily electrode change and effect on cardiac monitor alarms: an evidence-based practice approach[J]. J Nurs Care Qual, 2013, 28(3): 265-271. DOI:10.1097/NCQ.0b013e31827993bc.