ICU警报管理评价指标集的研究进展

doi:10.3761/j.issn.2096-7446.2026.02.020

摘要/Abstract

摘要：

ICU警报管理已成为国内外患者安全管理的重要主题。在设计警报管理项目时，选择恰当的结局评价指标对真实反映警报管理干预成效至关重要。该文对国内外ICU警报管理项目中的评价指标进行梳理分类，综述了ICU警报管理项目常见的评价指标集及其评价方法。警报管理评价指标设置应考虑主客观因素，包含结构（警报环境）、过程（警报数量、类型、时间、平衡措施）、结果（医护人员体验、行为，不良事件发生率）指标，以规范临床警报管理，但评价指标的有效性需进一步验证与完善。

关键词: 重症监护病房, 临床报警器, 警报管理, 质量指标，卫生保健, 综述文献专题

Abstract:

Alarm management in intensive care units has emerged as a critical component of patient safety initiatives globally. The selection of appropriate outcome measures is important when designing alarm management interventions to accurately assess their clinical efficacy. This review examines and categorizes evaluation indicators employed in ICU alarm management programs internationally，synthesizing commonly utilized indicator sets and assessment methodologies. A comprehensive alarm management evaluation indicator set should incorporate both objective and subjective parameters across three key domains：structural （alarm system infrastructure），process （alarm frequency，type，time patterns，and balancing metrics），and outcome measures （healthcare provider experience，behavioral responses，and adverse event rates），in order to standardize clinical alert management. However，the effectiveness of these evaluation indicators requires further verification and improvement.

Key words: Intensive Care Units, Clinical Alarms, Alarm Management, Quality Indicators，Health Care, Review Literature as Topic

王嘉一, 郭芝廷, 张玉萍, 王海珍, 黄晓霞, 金静芬. ICU警报管理评价指标集的研究进展[J]. 中华急危重症护理杂志, 2026, 7(2): 243-247.

WANG Jiayi, GUO Zhiting, ZHANG Yuping, WANG Haizhen, HUANG Xiaoxia, JIN Jingfen. Research progress on evaluation indicator set of ICU alarm management[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(2): 243-247.

参考文献 37

[1]	黄欢欢, 郑双江, 赵庆华, 等. 2022版《中国医院协会患者安全目标》更新解读[J]. 中国医院, 2023, 27(4):21-23.
	Huang HH, Zheng SJ, Zhao QH, et al. Interpretation of the update of “Patient Safety Goals of the Chinese Hospital Asso-ciation”(2022 version)[J]. Chin Hosp, 2023, 27(4):21-23.
[2]	The Joint Commission. Hospital:2025 national patient safety goals[Z]. 2025.
[3]	邱瑞瑾, 陈诗琪, 韩松洁, 等. 基于COMET数据库的核心指标集研究现状及进展[J]. 中国循证医学杂志, 2019, 19(5):622-629.
	Qiu RJ, Chen SQ, Han SJ, et al. The research status and pro-gress of core outcome sets based on COMET database[J]. Chin J Evid Based Med, 2019, 19(5):622-629.
[4]	Ryherd EE, Waye KP, Ljungkvist L. Characterizing noise and perceived work environment in a neurological intensive care unit[J]. J Acoust Soc Am, 2008, 123(2):747-756. doi: 10.1121/1.2822661 pmid: 18247879
[5]	Cvach M, Doyle P, Wong SY, et al. Decreasing pediatric PACU noise level and alarm fatigue:a quality improvement initiative to improve safety and satisfaction[J]. J Perianesth Nurs, 2020, 35(4):357-364. doi: 10.1016/j.jopan.2020.01.011
[6]	Rayo MF, Mansfield J, Eiferman D, et al. Implementing an ins-titution-wide quality improvement policy to ensure appropriate use of continuous cardiac monitoring:a mixed-methods retros-pective data analysis and direct observation study[J]. BMJ Qual Saf, 2016, 25(10):796-802. doi: 10.1136/bmjqs-2015-004137
[7]	Allan SH, Doyle PA, Sapirstein A, et al. Data-driven implemen-tation of alarm reduction interventions in a cardiovascular surgical ICU[J]. Jt Comm J Qual Patient Saf, 2017, 43(2):62-70.
[8]	Graham KC, Cvach M. Monitor alarm fatigue:standardizing use of physiological monitors and decreasing nuisance alarms[J]. Am J Crit Care, 2010, 19(1):28-34;quiz35. doi: 10.4037/ajcc2010651
[9]	Gorisek R, Mayer C, Braxton Hicks W, et al. An evidence-based initiative to reduce alarm fatigue in a burn intensive care unit[J]. Crit Care Nurse, 2021, 41(4):29-37. doi: 10.4037/ccn2021166 pmid: 34333620
[10]	Yang JK, Su F, Graber-Naidich A, et al. Mitigating alarm fati-gue and improving the bedside experience by reducing nona-ctionable alarms[J]. J Pediatr, 2025, 276:114278. doi: 10.1016/j.jpeds.2024.114278
[11]	Yeh J, Wilson R, Young L, et al. Team-based intervention to reduce the impact of nonactionable alarms in an adult in-tensive care unit[J]. J Nurs Care Qual, 2020, 35(2):115-122. doi: 10.1097/NCQ.0000000000000436
[12]	Sendelbach S, Wahl S, Anthony A, et al. Stop the noise:a quality improvement project to decrease electrocardiographic nuisance alarms[J]. Crit Care Nurse, 2015, 35(4):15-22. doi: 10.4037/ccn2015858 pmid: 26232798
[13]	Dandoy CE, Davies SM, Flesch L, et al. A team-based app-roach to reducing cardiac monitor alarms[J]. Pediatrics, 2014, 134(6):e1686-94. doi: 10.1542/peds.2014-1162
[14]	Yousefinya A, Torabizadeh C, Zand F, et al. Effectiveness of application of a manual for improvement of alarms mana-gement by nurses in Intensive Care Units[J]. Invest Educ En-ferm, 2021, 39(2):e11.
[15]	Arkilic LZ, Hundt E, Quatrara B. Critical care alarm fatigue and monitor customization:alarm frequencies and context factors[J]. Crit Care Nurse, 2024, 44(2):21-30. doi: 10.4037/ccn2024797 pmid: 38555968
[16]	Ruppel H, Funk M, Whittemore R. Measurement of physiolo-gical monitor alarm accuracy and clinical relevance in intensive care units[J]. Am J Crit Care, 2018, 27(1):11-21. doi: 10.4037/ajcc2018385
[17]	Lewis CL, Oster CA. Research outcomes of implementing CEASE:an innovative,nurse-driven,evidence-based,patient-customized monitoring bundle to decrease alarm fatigue in the intensive care unit/step-down unit[J]. Dimens Crit Care Nurs, 2019, 38(3):160-173. doi: 10.1097/DCC.0000000000000357
[18]	Stiglich YF, Dik PHB, Segura MS, et al. The alarm fatigue challenge in the neonatal intensive care unit:a “before” and “after” study[J]. Am J Perinatol, 2024, 41(S01):e2348-e2355. doi: 10.1055/a-2113-8364
[19]	Petersen EM, Costanzo CL. Assessment of clinical alarms in-fluencing nurses’ perceptions of alarm fatigue[J]. Dimens Crit Care Nurs, 2017, 36(1):36-44. pmid: 27902661
[20]	Winters BD. Effective approaches to control non-actionable alarms and alarm fatigue[J]. J Electrocardiol, 2018, 51(6S):S49-S51. doi: 10.1016/j.jelectrocard.2018.07.007 pmid: 30045808
[21]	Bonafide CP, Lin R, Zander M, et al. Association between ex-posure to nonactionable physiologic monitor alarms and res-ponse time in a children’s hospital[J]. J Hosp Med, 2015, 10(6):345-351. doi: 10.1002/jhm.v10.6
[22]	Bonafide CP, Russell Localio A, Holmes JH, et al. Video ana-lysis of factors associated with response time to physiologic monitor alarms in a children’s hospital[J]. JAMA Pediatr, 2017, 171(6):524-531. doi: 10.1001/jamapediatrics.2016.5123
[23]	Hedda S, Shashidhar A, Nesargi S, et al. An in-service educa-tional package improves alarm management in the neonatal intensive care unit(NICU):before and after study[J]. J Neo-natol, 2021, 35(4):214-218.
[24]	Belteki G, Morley CJ. Frequency,duration and cause of venti-lator alarms on a neonatal intensive care unit[J]. Arch Dis Child Fetal Neonatal Ed, 2018, 103(4):F307-F311.
[25]	Patel NZ, Patel DV, Phatak AG, et al. Reducing false alarms and alarm fatigue from pulse oximeters in a neonatal care unit:a quality improvement study[J]. J Neonatol, 2022, 36(2):135-142.
[26]	Sowan AK, Gomez TM, Tarriela AF, et al. Changes in default alarm settings and standard in-service are insufficient to improve alarm fatigue in an intensive care unit:a pilot project[J]. JMIR Hum Factors, 2016, 3(1):e1. doi: 10.2196/humanfactors.5098
[27]	Sahoo T, Joshi M, Madathil S, et al. Quality improvement ini-tiative for reduction of false alarms from multiparameter mo-nitors in neonatal intensive care unit[J]. J Educ Health Promot, 2019, 8:203.
[28]	Pater CM, Sosa TK, Boyer J, et al. Time series evaluation of improvement interventions to reduce alarm notifications in a paediatric hospital[J]. BMJ Qual Saf, 2020, 29(9):717-726. doi: 10.1136/bmjqs-2019-010368 pmid: 31959714
[29]	Sowan AK, Gomez TM, Tarriela AF, et al. Changes in default alarm settings and standard in-service are insufficient to improve alarm fatigue in an intensive care unit:a pilot pro-ject[J]. JMIR Hum Factors, 2016, 3(1):e1. doi: 10.2196/humanfactors.5098
[30]	Varisco G, van de Mortel H, Cabrera-Quiros L, et al. Optimisa-tion of clinical workflow and monitor settings safely reduces alarms in the NICU[J]. Acta Paediatr, 2021, 110(4):1141-1150. doi: 10.1111/apa.v110.4
[31]	Seifert M, Tola DH, Thompson J, et al. Effect of bundle set interventions on physiologic alarms and alarm fatigue in an intensive care unit:a quality improvement project[J]. Inten-sive Crit Care Nurs, 2021, 67:103098.
[32]	刘洁, 刘婧, 黄霞红, 等. ICU护士报警疲劳量表的汉化及信度效度检验[J]. 中国护理管理, 2021, 21(4):522-525.
	Liu J, Liu J, Huang XH, et al. Reliability and validity of the Chinese version of ICU nurses’ alarm fatigue questionnaire[J]. Chin Nurs Manag, 2021, 21(4):522-525.
[33]	Bi JS, Yin X, Li HY, et al. Effects of monitor alarm manage-ment training on nurses’ alarm fatigue:a randomised control-led trial[J]. J Clin Nurs, 2020, 29(21/22):4203-4216. doi: 10.1111/jocn.v29.21-22
[34]	Bosma S, Christopher R. Implementing a unit-based alarm ma-nagement bundle for critical care nurses[J]. Crit Care Nurse, 2023, 43(2):36-45. doi: 10.4037/ccn2023418
[35]	Sangari A, Bingham MA, Cummins M, et al. A spatiotemporal and multisensory approach to designing wearable clinical ICU alarms[J]. J Med Syst, 2023, 47(1):105. doi: 10.1007/s10916-023-01997-2 pmid: 37847469
[36]	Zhou YR, Zhao GS, Li J, et al. A contrastive learning app-roach for ICU false arrhythmia alarm reduction[J]. Sci Rep, 2022, 12(1):4689. doi: 10.1038/s41598-022-07761-9
[37]	Movahedi A, Sadooghiasl A, Ahmadi F, et al. A grounded theory study of alarm fatigue among nurses in intensive care units[J]. Aust Crit Care, 2023, 36(6):980-988. doi: 10.1016/j.aucc.2022.12.004 pmid: 36737263