Alarm response in critical care: Obstacles for compliance

Clinicians who are exposed to noisy environments are more likely to suffer from alarm fatigue, stress or sleep deprivation, and can finally become inefficient in the moment to respond to a critical situation. In other words, a lack of compliance or an inappropriate response to alarms is constantly observed in clinicians operating in critical care. In this paper, we introduce the issue of lack of compliance with medical alarms in critical care by contrasting the mandatory approaches stemming from safety and efficiency purposes (i.e., study of (cognitive) ergonomics) with a motivational approach (i.e., a user-centred study focusing on contextual inquiry). Based on in-situ observations carried out in intensive care units and the relevant literature review we define the obstacles for compliance deriving from psychological and contextual constraints and provide relevant insights to help designers and clinicians to fight with. Our aim is to initiate discussions regarding the main purpose of medical alarms and how to integrate them better in clinician workflow.