Assessment of nurses interventions in the Management of Clinical Alarms in the critical care unit, Kenyatta National Hospital, a cross sectional study

Abstract

Background: Alarms in the critical areas are an important component of most of the machines as they alert nurses on the change in the patients’ condition. Most patients in the critical care units cannot speak for themselves hence cannot pinpoint when their condition changes. It is therefore important to assess the nurses’ interventions when managing clinical alarms. The purpose of this study was to assess interventions employed by nurses in the management of clinical alarms in the care of patients in the Critical Care Unit (CCU), Kenyatta National Hospital (KNH). Methods: A descriptive cross sectional study was carried out in the month of June 2014 where 87 nurses were recruited as study respondents. KNH/ University of Nairobi (UoN) Ethics and Research committee approved the research. A structured self administered questionnaire was used to collect data. The questionnaire contained some questions in a Likert scale in relation to the actions the nurses would take in the management of clinical alarms and some on whether policies on alarm management existed in the hospital, if they filled alarm checklists and how often and the types of alarms they would respond to first. Results: The respondents’ responses were scored and from the results it was clear that there were some gaps in the management of clinical alarms. Majority of the nurses reported that they respond to alarms of all durations and do not fill alarm checklists as neither alarm checklists nor protocols are provided. From the findings there was a statistically significant association (p = 0.06) between age and whether the respondents assessed the cause of the alarm beep. Discussion: Respondents in this study respond to alarms of all durations in contrast to other studies where the findings indicate that nurses respond to alarms for different reasons, not just that the alarm sounds. Majority of the respondents scored averagely on the questions on whether they carry out most of the interventions or actions. This is inline with previous studies which have shown that healthcare personnel respond to alarms depending on the patient’s physiological status. Conclusions: Nurses in the unit carry out the standard nursing interventions on clinical alarms and, respond to alarms of all durations and do not fill alarm checklists. Alarm protocols should therefore be developed in the hospital, the nurses should be trained on management of clinical alarms and more nurses employed.