Correlations between monitor alarm workload and overall workload in Swedish emergency departments: a prospective multicenter cross-sectional study

Abstract

<title>Abstract</title> Background Emergency departments (ED) operate under conditions of high clinical demands, time-critical decisions and tasks. These characteristics can result in substantial workload on staff, which increases the risk of diagnostic errors and procedural delay, as well as negative effects on staff's wellbeing. To continuously monitor patients vital signs is an integral part of the ED working environment and enables healthcare workers to facilitate the observation of several patients simultaneously, preferably the most critically ill patients. In this study we investigate the correlation between emergency department staff's perceived alarm specific workload and overall workload, furthermore, identify if ED specific operational variables contribute to perceived alarm workload. Method A prospective cross-sectional study of ED staff assessment of overall workload and alarm workload was used through an online survey during clinical shifts with matched patient data from the electronic health record and monitor alarm data. Data was analyzed with a Pearson R test to determine the correlations of alarm specific workload and overall workload. Multivariate linear regression analysis was used to identify associations between alarm specific workload, workload and ED specific covariates. Results There is a correlation between ED staff's estimated alarm specific workload from monitoring equipment and overall workload, <italic>r</italic> = 0.53. In addition to workload, the proportions of patients <italic>arriving by ambulance</italic> and the <italic>frequency of technical alarms</italic> seem to affect the ED staff experience of alarm workload independently of overall workload. Conclusion Our findings confirm the close connection and associations between the two variables. The two modifiable ED specific factors of; <italic>amount of patients arriving by ambulance assigned to the ED team</italic> and <italic>frequency of technical alarms</italic> were in this study on their own a significant associated with an increase in experienced alarm workload on ED staff. This highlights that there are factors that may be amenable to intervention to reduce alarm workload apart from targeting workload.