Alarm setting for the critically ill patient: a descriptive pilot survey of nurses' perceptions of current practice in an Australian Regional Critical Care Unit.

AIM: The aim of this survey was to assess registered nurse's perceptions of alarm setting and management in an Australian Regional Critical Care Unit. BACKGROUND: The setting and management of alarms within the critical care environment is one of the key responsibilities of the nurse in this area. However, with up to 99% of alarms potentially being false-positives it is easy for the nurse to become desensitised or fatigued by incessant alarms; in some cases up to 400 per patient per day. Inadvertently ignoring, silencing or disabling alarms can have deleterious implications for the patient and nurse. METHOD: A total population sample of 48 nursing staff from a 13 bedded ICU/HDU/CCU within regional Australia were asked to participate. A 10 item open-ended and multiple choice questionnaire was distributed to determine their perceptions and attitudes of alarm setting and management within this clinical area. RESULTS: Two key themes were identified from the open-ended questions: attitudes towards inappropriate alarm settings and annoyance at delayed responses to alarms. A significant number of respondents (93%) agreed that alarm fatigue can result in alarm desensitisation and the disabling of alarms, whilst 81% suggested the key factors are those associated with false-positive alarms and inappropriately set alarms. CONCLUSION: This study contributes to what is known about alarm fatigue, setting and management within a critical care environment. In addition it gives an insight as to what nurses' within a regional context consider the key factors which contribute to alarm fatigue. Clearly nursing burnout and potential patient harm are important considerations for practice especially when confronted with alarm fatigue and desensitisation. Therefore, promoting and maintaining an environment of ongoing intra-professional communication and alarm surveillance are crucial in alleviating these potential problems.

The effect of playing formation on high-intensity running and technical profiles in English FA Premier League soccer matches.

The aim of this study was to examine the effect of playing formation on high-intensity running and technical performance during elite soccer matches. Twenty English FA Premier League games were analysed using a multiple-camera computerized tracking system (n = 153 players). Overall ball possession did not differ (P < 0.05) between 4-4-2, 4-3-3 and 4-5-1 formations (50%, s = 7 vs. 49%, s = 8 vs. 44%, s = 6). No differences were observed in high-intensity running between 4-4-2, 4-3-3 and 4-5-1 formations. Compared with 4-4-2 and 4-3-3 formations, players in a 4-5-1 formation performed less very high-intensity running when their team was in possession (312 m, s = 196 vs. 433 m, s = 261 vs. 410 m, s = 270; P 5 0.05) but more when their team was not in possession (547 m, s = 217 vs. 461 m, s = 156 vs. 459 m, s = 169; P < 0.05). Attackers in a 4-3-3 performed ~30% more (P < 0.05) high-intensity running than attackers in 4-4-2 and 4-5-1 formations. However, the fraction of successful passes was highest in a 4-4-2 (P < 0.05) compared with 4-3-3 and 4-5-1 formations. The results suggest that playing formation does not influence the overall activity profiles of players, except for attackers, but impacts on very high-intensity running activity with and without ball possession and some technical elements of performance.