Organizing Audible Alarm Sounds in the Hospital: A Card-Sorting Study

In hospitals, clinicians are presented with varied and disorganized alarm sounds from disparate devices. While there has been attention to reducing inactionable alarms to address alarm overload, little effort has been focused on organizing, simplifying, or improving the informativeness of alarms. In this article, we sought to elicit nurses' tacit interpretation of alarm events to create an organizational structure to inform the design of advanced alarm sounds or integrated alert systems. We used open card sorting to evaluate nurses' perception of the relatedness of different alarm events. A total of 70 hospital nurses sorted 89 alarm events into groups they believed could or should be indicated by the same sound. We conducted a factor analysis on a similarity matrix of the frequency of alarm event pairings to interpret how strongly alarm events loaded on different alarm groups (factors). We interpreted participants' grouping rationale from their group labels and comments. The urgency of response was the most common grouping rationale. Participants also grouped monitoring-related events, device-related events, and events related to calls and patients. Our findings support the standardization and integration of alarm sounds across devices toward a simpler and more informative hospital alarm environment.