OBJECTIVES: Describe the frequency and pattern of monitor alarms in the emergency department (ED), in combination with exploring the staff's experience of alarms and alarm fatigue. METHODS: This was a multicenter, mixed-method study of observational monitor alarms and semistructured staff interviews with inductive qualitative content analysis from 3 EDs in Sweden. The primary measures were alarm frequency and confirmation times. Quantile regression was used to analyze the association between alarms and confirmation times. RESULTS: In total, 396,011 alarms were registered during the data collection period, or 1 alarm every 30 seconds in the urban and academic centers and every 120 seconds in the rural hospital, on average. Median confirmation times were 11 seconds for high severity alarms (IQR, 5-33) and 132 seconds for low severity alarms (IQR, 15-878). This increased by 1 second when alarms per hour increased by 128 (95% CI, 67-1000
CONCLUSION: ED staff work in an alarm environment prone to alarm fatigue with frequent alarms and several system-related factors that increase the risk of alarm fatigue, which is mitigated by the individual health care worker.