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Alert Fatigue, Health Personnel

MedGen UID:
898728
•Concept ID:
C4277642
•
Mental or Behavioral Dysfunction
Synonyms: Alarm Fatigue; Alert Fatigue Health Personnel; Fatigue, Alarm; Health Personnel Alert Fatigue

Definition

Mental fatigue experienced by health care providers who encounter numerous alerts and reminders from the use of CLINICAL DECISION SUPPORT SYSTEMS. As the numbers of alerts and reminders designed to provide meaningful assistance to the patient care process increases, many health personnel may ignore them. [from MeSH]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVAlert Fatigue, Health Personnel

Professional guidelines

PubMed

General practitioner and nurse practitioner attitudes towards electronic reminders in primary care: a qualitative analysis.
Cecil E, Dewa LH, Ma R, Majeed A, Aylin P
BMJ Open 2021 Jul 12;11(7):e045050. doi: 10.1136/bmjopen-2020-045050. PMID: 34253661Free PMC Article
Facilitation or Hindrance: Physicians' Perception on Best Practice Alerts (BPA) Usage in an Electronic Health Record System.
Chen H, Butler E, Guo Y, George T Jr, Modave F, Gurka M, Bian J
Health Commun 2019 Aug;34(9):942-948. Epub 2018 Feb 27 doi: 10.1080/10410236.2018.1443263. PMID: 29485296
Primary care provider adherence to an alert for intensification of diabetes blood pressure medications before and after the addition of a "chart closure" hard stop.
Ramirez M, Maranon R, Fu J, Chon JS, Chen K, Mangione CM, Moreno G, Bell DS
J Am Med Inform Assoc 2018 Sep 1;25(9):1167-1174. doi: 10.1093/jamia/ocy073. PMID: 30060013Free PMC Article

Recent clinical studies

Etiology

Pro-Con Debate: Universal Versus Selective Continuous Monitoring of Postoperative Patients.
Blike GT, McGrath SP, Ochs Kinney MA, Gali B
Anesth Analg 2024 May 1;138(5):955-966. Epub 2024 Apr 15 doi: 10.1213/ANE.0000000000006840. PMID: 38621283
Nurses' alarm fatigue, influencing factors, and its relationship with burnout in the critical care units: A cross-sectional study.
Nyarko BA, Yin Z, Chai X, Yue L
Aust Crit Care 2024 Mar;37(2):273-280. Epub 2023 Aug 12 doi: 10.1016/j.aucc.2023.06.010. PMID: 37580238
Medication safety alert fatigue may be reduced via interaction design and clinical role tailoring: a systematic review.
Hussain MI, Reynolds TL, Zheng K
J Am Med Inform Assoc 2019 Oct 1;26(10):1141-1149. doi: 10.1093/jamia/ocz095. PMID: 31206159Free PMC Article
Utility of Electronic Medical Record Alerts to Prevent Drug Nephrotoxicity.
Martin M, Wilson FP
Clin J Am Soc Nephrol 2019 Jan 7;14(1):115-123. Epub 2018 Apr 5 doi: 10.2215/CJN.13841217. PMID: 29622668Free PMC Article
Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system.
Ancker JS, Edwards A, Nosal S, Hauser D, Mauer E, Kaushal R; with the HITEC Investigators
BMC Med Inform Decis Mak 2017 Apr 10;17(1):36. doi: 10.1186/s12911-017-0430-8. PMID: 28395667Free PMC Article

Diagnosis

Nurses' alarm fatigue, influencing factors, and its relationship with burnout in the critical care units: A cross-sectional study.
Nyarko BA, Yin Z, Chai X, Yue L
Aust Crit Care 2024 Mar;37(2):273-280. Epub 2023 Aug 12 doi: 10.1016/j.aucc.2023.06.010. PMID: 37580238
COVID-19 Fatigue: Not So Fast.
O'Connor CM
JACC Heart Fail 2020 Jul;8(7):592-594. Epub 2020 Jun 4 doi: 10.1016/j.jchf.2020.06.001. PMID: 32616168Free PMC Article
Utility of Electronic Medical Record Alerts to Prevent Drug Nephrotoxicity.
Martin M, Wilson FP
Clin J Am Soc Nephrol 2019 Jan 7;14(1):115-123. Epub 2018 Apr 5 doi: 10.2215/CJN.13841217. PMID: 29622668Free PMC Article
Diagnostic heuristics in dermatology, part 2: metacognition and other fixes.
Lowenstein EJ, Sidlow R
Br J Dermatol 2018 Dec;179(6):1270-1276. Epub 2018 Oct 14 doi: 10.1111/bjd.17127. PMID: 30171684
Patient Safety Implications of Electronic Alerts and Alarms of Maternal - Fetal Status During Labor.
Simpson KR, Lyndon A, Davidson LA
Nurs Womens Health 2016 Aug-Sep;20(4):358-66. doi: 10.1016/j.nwh.2016.07.004. PMID: 27520600

Therapy

Renal medication-related clinical decision support (CDS) alerts and overrides in the inpatient setting following implementation of a commercial electronic health record: implications for designing more effective alerts.
Shah SN, Amato MG, Garlo KG, Seger DL, Bates DW
J Am Med Inform Assoc 2021 Jun 12;28(6):1081-1087. doi: 10.1093/jamia/ocaa222. PMID: 33517413Free PMC Article
Mechanical Ventilation Alarms and Alarm Fatigue.
Scott JB, De Vaux L, Dills C, Strickland SL
Respir Care 2019 Oct;64(10):1308-1313. Epub 2019 Jun 18 doi: 10.4187/respcare.06878. PMID: 31213570
Successful deployment of drug-disease interaction clinical decision support across multiple Kaiser Permanente regions.
Bubp JL, Park MA, Kapusnik-Uner J, Dang T, Matuszewski K, Ly D, Chiang K, Shia S, Hoberman B
J Am Med Inform Assoc 2019 Oct 1;26(10):905-910. doi: 10.1093/jamia/ocz020. PMID: 30986823Free PMC Article
Clinical decisions support malfunctions in a commercial electronic health record.
Kassakian SZ, Yackel TR, Gorman PN, Dorr DA
Appl Clin Inform 2017 Sep 6;8(3):910-923. doi: 10.4338/ACI-2017-01-RA-0006. PMID: 28880046Free PMC Article
Patient Safety Implications of Electronic Alerts and Alarms of Maternal - Fetal Status During Labor.
Simpson KR, Lyndon A, Davidson LA
Nurs Womens Health 2016 Aug-Sep;20(4):358-66. doi: 10.1016/j.nwh.2016.07.004. PMID: 27520600

Prognosis

Pro-Con Debate: Universal Versus Selective Continuous Monitoring of Postoperative Patients.
Blike GT, McGrath SP, Ochs Kinney MA, Gali B
Anesth Analg 2024 May 1;138(5):955-966. Epub 2024 Apr 15 doi: 10.1213/ANE.0000000000006840. PMID: 38621283
Automated Identification of Adults at Risk for In-Hospital Clinical Deterioration.
Escobar GJ, Liu VX, Schuler A, Lawson B, Greene JD, Kipnis P
N Engl J Med 2020 Nov 12;383(20):1951-1960. doi: 10.1056/NEJMsa2001090. PMID: 33176085Free PMC Article
Actionable Ventricular Tachycardia During In-Hospital ECG Monitoring and Its Impact on Alarm Fatigue.
Pelter MM, Suba S, Sandoval C, Zègre-Hemsey JK, Berger S, Larsen A, Badilini F, Hu X
Crit Pathw Cardiol 2020 Jun;19(2):79-86. doi: 10.1097/HPC.0000000000000216. PMID: 32102049Free PMC Article
A Potential Answer to the Alert Override Riddle: Using Patient Attributes to Predict False Positive Alerts.
Kennell TI Jr, Cimino JJ
AMIA Annu Symp Proc 2019;2019:532-541. Epub 2020 Mar 4 PMID: 32308847Free PMC Article
Clinical decisions support malfunctions in a commercial electronic health record.
Kassakian SZ, Yackel TR, Gorman PN, Dorr DA
Appl Clin Inform 2017 Sep 6;8(3):910-923. doi: 10.4338/ACI-2017-01-RA-0006. PMID: 28880046Free PMC Article

Clinical prediction guides

Pro-Con Debate: Universal Versus Selective Continuous Monitoring of Postoperative Patients.
Blike GT, McGrath SP, Ochs Kinney MA, Gali B
Anesth Analg 2024 May 1;138(5):955-966. Epub 2024 Apr 15 doi: 10.1213/ANE.0000000000006840. PMID: 38621283
Interdisciplinary collaboration in critical care alarm research: A bibliometric analysis.
Agha-Mir-Salim L, McCullum L, Dähnert E, Scheel YD, Wilson A, Carpio M, Chan C, Lo C, Maher L, Dressler C, Balzer F, Celi LA, Poncette AS, Pelter MM
Int J Med Inform 2024 Jan;181:105285. Epub 2023 Nov 7 doi: 10.1016/j.ijmedinf.2023.105285. PMID: 37977055
Nurses' alarm fatigue, influencing factors, and its relationship with burnout in the critical care units: A cross-sectional study.
Nyarko BA, Yin Z, Chai X, Yue L
Aust Crit Care 2024 Mar;37(2):273-280. Epub 2023 Aug 12 doi: 10.1016/j.aucc.2023.06.010. PMID: 37580238
Alarm Fatigue in the Intensive Care Unit: Relevance and Response Time.
Andrade-Méndez B, Arias-Torres DO, Gómez-Tovar LO
Enferm Intensiva (Engl Ed) 2020 Jul-Sep;31(3):147-153. Epub 2020 Apr 26 doi: 10.1016/j.enfi.2019.11.002. PMID: 32349945
Clinical decisions support malfunctions in a commercial electronic health record.
Kassakian SZ, Yackel TR, Gorman PN, Dorr DA
Appl Clin Inform 2017 Sep 6;8(3):910-923. doi: 10.4338/ACI-2017-01-RA-0006. PMID: 28880046Free PMC Article

Recent systematic reviews

Optimizing clinical decision support alerts in electronic medical records: a systematic review of reported strategies adopted by hospitals.
Van Dort BA, Zheng WY, Sundar V, Baysari MT
J Am Med Inform Assoc 2021 Jan 15;28(1):177-183. doi: 10.1093/jamia/ocaa279. PMID: 33186438Free PMC Article
Medication safety alert fatigue may be reduced via interaction design and clinical role tailoring: a systematic review.
Hussain MI, Reynolds TL, Zheng K
J Am Med Inform Assoc 2019 Oct 1;26(10):1141-1149. doi: 10.1093/jamia/ocz095. PMID: 31206159Free PMC Article
Measurement of Physiological Monitor Alarm Accuracy and Clinical Relevance in Intensive Care Units.
Ruppel H, Funk M, Whittemore R
Am J Crit Care 2018 Jan;27(1):11-21. doi: 10.4037/ajcc2018385. PMID: 29292271

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