Other Titles
Facilitators, Barriers to Successful Implementation of Alarm Management in ICU: A Meta-Synthesis Using the CFIR [Title Slide]
Abstract
A literature search of four English-language databases (PubMed, Web of Science, Embase, the Cochrane Library) and three Chinese-language databases (China National Knowledge Infrastructure, Wan Fang, VIP Database). Studies from inception to October 1 2025 published in English or Chinese using qualitative or mixed methods to explore alarm management practices in intensive care units were included. Based on the Consolidated Framework for Implementation Research (CFIR) 1, data were synthesized by classifying influencing factors into the five domains and 48 constructs. Key domains and factors were identified through frequency analysis across and within domains. The Joanna Briggs Institute Qualitative Assessment was used to appraise methodologic quality2.
Findings: Twenty-five studies were included and appraised according to the CFIR (in parentheses). We identified 55 factors, mostly linked to three domains of the CFIR: Inner setting, Individuals and Implementation process. The most common facilitators were "the optimization of intelligent alarm systems"(Inner setting), "the enhancement of nurses' clinical decision-making abilities"(Individuals), "the drive from nurses' sense of professional achievement"(Individuals) and "effective collaboration within multi-disciplinary teams"(Implementation process). The most common barriers were "the inherent high sensitivity and low specificity of patient monitors"(Inner setting), "insufficient and ineffective training"(Inner setting), "diminished alarm response due to nurse psychological and physiological fatigue"(Individuals), "the challenging auditory environment of the clinical setting"(Implementation process) and "frequent workflow interruptions"(Implementation process).
Conclusions: The identified factors provide a foundational checklist for implementing multidisciplinary alarm management. Integrating smart alarms with enhanced training and collaboration could address key issues like false alarms and staff alarm fatigue, while future research should develop specific implementation strategies based on these findings.
Notes
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References:
1. Damschroder LJ, Reardon CM, Widerquist MAO, Lowery J. The updated Consolidated Framework for Implementation Research based on user feedback. Implement Sci. 2022;17(1):75.
2. Joanna Briggs Institute. JBI critical appraisal checklist for qualitative research. http://Joannabriggs.org/assets/docs/critical-appraisal-tools.html. Accessed Feb 12th, 2016.
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Systematic Review
Research Approach
Qualitative Research
Keywords:
Equipment Alarm Systems, Critical Care Nurses, Intensive Care Units, Alarm Fatigue, Fatigue, Mental Fatigue, Implementation Science, Conceptual Framework, CFIR
Recommended Citation
Wang, Jiayi; Mao, Yitong; Guo, Zhiting; Zhang, Yuping; and Jin, Jingfen, "Facilitators and Barriers to Alarm Management in ICU: A Qualitative Systematic Review Using CFIR" (2026). International Nursing Research Congress (INRC). 241.
https://www.sigmarepository.org/inrc/2026/presentations_2026/241
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-29
Facilitators and Barriers to Alarm Management in ICU: A Qualitative Systematic Review Using CFIR
Toronto, Ontario, Canada
A literature search of four English-language databases (PubMed, Web of Science, Embase, the Cochrane Library) and three Chinese-language databases (China National Knowledge Infrastructure, Wan Fang, VIP Database). Studies from inception to October 1 2025 published in English or Chinese using qualitative or mixed methods to explore alarm management practices in intensive care units were included. Based on the Consolidated Framework for Implementation Research (CFIR) 1, data were synthesized by classifying influencing factors into the five domains and 48 constructs. Key domains and factors were identified through frequency analysis across and within domains. The Joanna Briggs Institute Qualitative Assessment was used to appraise methodologic quality2.
Findings: Twenty-five studies were included and appraised according to the CFIR (in parentheses). We identified 55 factors, mostly linked to three domains of the CFIR: Inner setting, Individuals and Implementation process. The most common facilitators were "the optimization of intelligent alarm systems"(Inner setting), "the enhancement of nurses' clinical decision-making abilities"(Individuals), "the drive from nurses' sense of professional achievement"(Individuals) and "effective collaboration within multi-disciplinary teams"(Implementation process). The most common barriers were "the inherent high sensitivity and low specificity of patient monitors"(Inner setting), "insufficient and ineffective training"(Inner setting), "diminished alarm response due to nurse psychological and physiological fatigue"(Individuals), "the challenging auditory environment of the clinical setting"(Implementation process) and "frequent workflow interruptions"(Implementation process).
Conclusions: The identified factors provide a foundational checklist for implementing multidisciplinary alarm management. Integrating smart alarms with enhanced training and collaboration could address key issues like false alarms and staff alarm fatigue, while future research should develop specific implementation strategies based on these findings.
Description
This session employs the Consolidated Framework for Implementation Research (CFIR) to systematically deconstruct and map the complex system of ICU alarm management. We will present a comprehensive synthesis of evidence, delineating the critical barriers and facilitators across the five core domains: innovation characteristics, outer setting, inner setting, Characteristics of Individuals, and the implementation process itself.