Critical Care Nurses' Cognitive Ergonomics Related to Medical Device Alarms.

This study uniquely gained insight into the intricacy of intensive care nurses' decision-making process when responding to and managing device alarms. Difficulty in responding to alarms included low staffing, multiple job responsibilities, and competing priority tasks. Novice nurses are more tolerant of alarms sounding owing to a lower threshold of comfort with resetting or silencing alarms; more experienced nurses are more comfortable resetting alarm limits to the patient's baseline. Understanding the decision-making process used by nurses can guide the development of policies and learning experiences that are crucial clinical support for alarm management.

Designing a critical care nurse-led rapid response team using only available resources: 6 years later.

Rapid response teams have been introduced to intervene in the care of patients whose condition deteriorates unexpectedly by bringing clinical experts quickly to the patient's bedside. Evidence supporting the need to overcome failure to deliver optimal care in hospitals is robust; whether rapid response teams demonstrate benefit by improving patient safety and reducing the occurrence of adverse events remains controversial. Despite inconsistent evidence regarding the effectiveness of rapid response teams, concerns regarding care and costly consequences of unaddressed deterioration in patients' condition have prompted many hospitals to implement rapid response teams as a patient safety strategy. A cost-neutral structure for a rapid response team led by a nurse from the intensive care unit was implemented with the goal of reducing cardiopulmonary arrests occurring outside the intensive care unit. The results of 6 years' experience indicate that a sustainable and effective rapid response team response can be put into practice without increasing costs or adding positions and can decrease the percentage of cardiopulmonary arrests occurring outside the intensive care unit.