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. 2025 Sep 2;24(1):1157.
doi: 10.1186/s12912-025-03781-8.

Assessment of alarm fatigue among intensive care unit nurses: a cross-sectional study

Anja Hohenwallner  1 , Marina Ufelmann  2 , Andrea Ellermeyer  2 , Anna Scholze  1 , Laura Borgstedt  1 , Akira-Sebastian Poncette  3   4 , Kristina Fuest  5
Affiliations

Assessment of alarm fatigue among intensive care unit nurses: a cross-sectional study

Anja Hohenwallner et al. BMC Nurs. .

Abstract

Background: Alarm fatigue occurs when ICU personnel are exposed to an excessive number of alarms, resulting in desensitization, improper alarm management, and reduced patient safety. This study aimed to assess the extent of alarm fatigue among ICU nurses at a German university hospital using the Charité Alarm Fatigue Questionnaire (CAFQa) and to examine differences based on working hours and professional experience.

Methods: An observational cross-sectional study design was used. Data were collected via an online survey from nurses working in five intensive care units (ICUs) of a German university hospital between January and March 2024. The questionnaire comprised 27 items based on the Charité Alarm Fatigue Questionnaire (CAFQa). Additionally, participants rated their perceived alarm fatigue on a visual analogue scale ranging from 0 to 100%. Above that, participants were asked to provide information regarding their ICU experience and monthly workdays. Statistical significance was assessed using two-sample t-tests. Correlations between CAFQa scores and self-reported alarm fatigue were analysed using Pearson's correlation coefficient. A p-value of < 0.05 was considered statistically significant.

Results: A total of 70 ICU nurses participated in the study. No significant differences in alarm fatigue were found between nurses working more than eight days per month and those working fewer days (t(56) = 1.00, p = 0.32), and with more than one year of ICU experience and less experience, respectively (t(56) = 1.32, p = 0.19). Complete CAFQa data were available for 59 participants. The mean CAFQa score was (17.7 ± 5.5) points out of 36 points ((49 ± 15) %), indicating moderate to high alarm fatigue. Individual scores ranged from 5 (14%) to 28 (78%). The average self-reported alarm fatigue was (47 ± 22) %.

Conclusions: Alarm fatigue is present among ICU nurses in moderate to high levels, but no significant differences were observed based on working hours or professional experience. Since alarm fatigue may have grave repercussions for nurses and patients, recognition and implementation of effective strategies to minimise it are crucial.

Trial registration: Clinical trial number: Not applicable.

Keywords: Alarm fatigue; Clinical alarms; Critical care nurse; Intensive care unit; Patient safety.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This analysis is covered by the approval of the ethics committee of the School of Medicine and Health, Technical University of Munich (Ismaninger Straße 22, 81675 Munich, Chairperson Prof. Dr. G. Schmidt, Reference 264/21S) as well as the hospital’s workers council. Participation in this study was entirely voluntary and anonymous. No separate informed consent procedure was necessary. Consent was implied by the return of the questionnaire. The study was conducted in accordance with the Declaration of Helsinki. Clinical trial number: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
CAFQa alarm fatigue score distribution. Distribution of the participants’ CAFQa scores (n = 59). Numbers are presented as percentage (CAFQa Score) and counts (Frequency). Blue bars represent the observed frequency, while the black line indicates the corresponding Gaussian fit
Fig. 2
Fig. 2
Self-evaluation vs. CAFQa score. Correlation between self-evaluated alarm fatigue and CAFQa scores. Scatterplot illustrating the relationship between self-reported alarm fatigue (%) and CAFQa scores (%) among ICU nurses (n = 59). Each point represents an individual participant. The solid line indicates the linear regression fit. A significant positive correlation was observed (Pearson’s r = 0.52; p < 0.0001)
See this image and copyright information in PMC

References

    1. ECRI Institute. Top 10 Health Technology Hazards for 2020 Executive Brief. 2019. Available from: https://assets.ecri.org/PDF/White-Papers-and-Reports/ECRI-Top-10-Technol.... Accessed 15 April 2025.
    1. Wunderlich MM, Amende-Wolf S, Krampe H, Kruppa J, Spies C, Weiß B, et al. A brief questionnaire for measuring alarm fatigue in nurses and physicians in intensive care units. Sci Rep. 2023;13:13860. 10.1038/s41598-023-40290-7. - PMC - PubMed
    1. Michels EAM, Gilbert S, Koval I, Wekenborg MK. Alarm fatigue in healthcare: a scoping review of definitions, influencing factors, and mitigation strategies. BMC Nurs. 2025;24:664. 10.1186/s12912-025-03369-2. - PMC - PubMed
    1. Cvach M. Monitor alarm fatigue: an integrative review. Biomed Instrum Technol. 2012;46(4):268–77. 10.2345/0899-8205-46.4.268. - PubMed
    1. Hayhurst C. Right alert, Right time: developing clinically meaningful, actionable alarm notifications. Biomed Instrum Technol. 2020;54(1):12–20. 10.2345/0899-8205-54.1.12 - PubMed

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