Raising Students' Clinical Alarm Awareness: Evaluating a Learning Activity

Abstract

The American College of Clinical Engineering (ACCE) has found that lack of attention to alarms applies to both experienced and inexperi- enced practicing nurses (ACCE Healthcare Technology Foundation, 2006). The Joint Commission also notes safety concerns that arise from a lack of attention to clinical alarms (HCPro, 2005). A literature review on attentiveness in the workplace indicates that concentrating on another task, fatigue, distractions, and numerous alarms (some of which are false) can interfere with an individual's capacity to pay attention (Curry, Meyer, & McKinney, 2006; Institute for Safe Medication Practices, 2009; Mack & Roche, 1998, as cited in Karns & Rivardo, 2010).In response to concerns by the Quality and Safety Education for Nurses (QSEN) Committee regarding the gap between the learning envi- ronment and practice (Thornlow & McGuinn, 2010), Ardoin and Wilson attempted to connect the classroom to the practice setting by using Spencer and Foss' (2009) Clinical Alarm Safety learning activity with a group of eight junior baccalaureate nursing (BSN) students. Comments and actions from this group of students validated that the activity met the QSEN 2011 proposed targets for knowledge, skills, and attitudes. Although students were found to begin to internalize new values for alarm recognition and safety (Ardoin & Wilson, 2014), it was uncertain whether their heightened awareness of clinical alarms was due to the learning activity or simply from the exposure to alarms on a clinical unit.The intent of this study was to determine if first-semester junior BSN students showed heightened awareness of clinical alarms in their student practice after using the Spencer and Foss (2009) learning activity. It was hoped that positive findings would support the integra- tion of the activity in the curriculum and a reevaluation of the students' clinical alarm awareness upon graduation and one year thereafter.methodStudy DesignA quasi-experimental descriptive study, with a nonequivalent con- trol group design, allowed for subjecting half the class to the learn- ing activity and for following the same group of students over time (Polit & Beck, 2010). Students completed the Students' Clinical Alarm Awareness Survey at the beginning and end of the semester. To ensure anonymity, no signatures were required.Population and SampleFollowing approval from the university's institutional review board, students learned of the research study's purpose and voluntary nature and that participation would not affect their course grade. A nonprob- ability convenience selection tapered a population of 78 first-semester junior BSN students to 58. Four experimental groups (EG) contained a total of 24 students, and four control groups (CG) had 34 students; no group had more than 10 students. Students with previous and/or current hospital experience were excluded from the study.InstrumentThe Students' Clinical Alarm Awareness Survey was a modification (with permission) of the 2006 Clinical Alarm Awareness Survey devel- oped by the ACCE (ACCE Healthcare Technology Foundation, 2006). No reliability or validity testing of previous versions of the survey has been reported in the literature. The modified survey centers on stu- dents in a learning situation versus practicing nurses in the workplace. The original survey consisted of 26 items; to focus on student aware- ness of clinical alarms, a panel of five nursing professors reestablished face and content validity for nine items in the modified version. The panelists felt the instrument looked appropriate and contained an ade- quate representation of the construct (Polit & Beck, 2010).Data AnalysisStatistical Package for the Social Sciences (SPSS) predictive software, version 18.0.3, was used to analyze data. RM-ANOVA was used to examine group differences over time. Applying p values