The Impact of False Alarms on Mental Workload, Stress and Performance: Implications for Medical Settings

Abstract

The excessive number of auditory and false alarms (FAs) in medical settings (e.g. ICUs) negatively impact alarm response and performance on ongoing tasks. We examined the impact of two FA rates (low-40% and high-80% in a counterbalanced order repeated measures design) on 36 participants’ alarm responses with a concurrent working-memory (N-back) task. Participants made significantly more responses to FAs in the high FA condition relative to the low FA condition. An FA rate and order interaction revealed that participants who started in the low FA condition responded to fewer FAs in both the high and low FA conditions. Participants who started in the high FA condition responded to more than twice the number of FAs in the high FA condition compared to the low FA condition. Similarly, response time to correct detections (Hits) in the alarm and N-back tasks also revealed interaction effects between order and FA conditions. Participants who received the low FA condition first responded faster to true alarms in the high FA condition compared to those who received the high FA condition first. No significant main effects or interactions were observed for the number of Hits on the alarm task, response times to FAs in either task, nor for subjective ratings of mental workload or stress. Significant main and interaction effects observed on the N-back task were likely attributable to practice effects. These results underscore the need to reduce the number of FAs in medical settings and have implications for designing training paradigms to improve provider performance.