1. Stacy, Kathleen M. PhD, RN, CNS, CCRN, PCCN, CCNS

Article Content


The purpose of this qualitative study was to develop a broader understanding of the contextual factors that influence the acute care registered nurse's response to clinical alarms in the patient care setting.



Nurses are faced with a multitude of clinical alarms on a daily basis. There is an inherent expectation that upon hearing an alarm, the nurse will immediately respond to assess the situation and initiate appropriate action to correct the problem. Yet this does not always occur. Any problem with an alarm poses a serious threat to patient safety.



This qualitative study used an interpretive phenomenological methodology to study the lived experiences of registered nurses who encounter clinical alarms in the medical-surgical unit.



The study was conducted in 2 community hospitals in southern California over a 9-week period. Four focus groups were conducted with a total of 28 participants. A tiered schedule approach was used to facilitate concurrent analysis and refinement of the interview questions. Data saturation was achieved after the last focus group. Participants had to have at least 1 year of full-time experience. Each focus group was audiotaped and each tape was transcribed. The transcripts were analyzed for central themes related to alarm response.



The sample consisted of 28 participants whose average age was 42.8 years, had been an RN for 10.9 years, and had been in their current position for 4.3 years. The majority of the sample was female (96%) and worked full-time (75%) on the day shift (61%). Sixty-four percent of the sample held an associate degree, 22% had a baccalaureate degree, and 14% had a master's degree. Several themes emerged from the transcript analysis. Contextual factors that influenced the nurse's response to alarms included perceived importance of the alarm, experience, unit leadership and culture, and fatigue.



The participants in this study responded to alarms in the order of perceived importance. Factors that influenced their perception included patient safety, alleviation of pain, and patient satisfaction.


Implications for Practice:

Clinical nurse specialists can use this evidence to promote safer nursing care of medical-surgical patients with regard to ever-increasing technology.


Section Description

The 2010 National Association of Clinical Nurse Specialists (NACNS) Annual National Conference is planned for Portland, Oregon, on March 3 to 6. More than 375 clinical nurse specialists (CNSs), graduate faculty, nurse administrators, nurse researchers, and graduate students are expected to attend. This year's theme, "CNS as Internal Consultant: Influencing Local to Global Systems," demonstrates the breadth and depth of CNS practice and leadership at multiple levels in organizations and on healthcare.


A total of 142 abstracts were submitted for review, and 58 (not including student posters) were selected for either podium or poster presentations. Again, this year, there is a CNS student poster session; student abstracts will appear in a later issue of the journal. The abstracts addressed CNS practice in all 3 practice domains as described in the Spheres of Influence Framework for CNS Practice. Abstracts emphasized patient safety and quality care outcomes, leadership, CNS education, evidence-based practice, and new ways to shape CNS practice. Topics include CNS work activities incorporated into the 3 Spheres of Influence, the role of the CNS in developing clinical inquiry skills among staff nurses, use of simulation technology, strategies to maintain clinical excellence, the role of the CNS in National Database for Nursing Quality Indicators (NDNQI) activities, and many new and thoughtful ideas to support CNS education, practice, and research. Collectively, the abstracts represent the breadth, depth, and richness of the CNS's contribution to the well-being of individuals, families, and communities, as well as contributing to the advancement of the nursing profession.


The conference abstracts are published to share new knowledge with those unable to attend the conference. As you read each abstract, appreciate the intellectual talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to the health of society through improved outcomes for patients and healthcare organizations. We encourage you to contact individual presenters to network, collaborate, consult, or share your thoughts and ideas on the conference topics.


Watch for next year's call for abstracts and consider submitting for presentation at the next NACNS annual conference scheduled for March 9-12, 2011, in Baltimore, Maryland.