Assessing the Performance of Nurses in the Proper Adjustment of Monitoring Instruments in the Neonatal Intensive Care Unit

Monitoring serves to maintain physiologic variables within normal limits and when a parameter crosses a set threshold, an alarm is triggered. Therefore, this study aimed to determine whether alarm limits are properly adjusted in the neonatal intensive care unit (NICU) by nursing staff or not. The data concerning alarm limits corresponding to the three shifts of nursing work were recorded for the newborns with cardiorespiratory problems, such as hyaline membrane disease, transient tachypnea of the newborns, and pneumonia, who were admitted to the NICU of Imam Reza Hospital, Mashhad, Iran during March 2016-December 2016. The findings of this study showed that 75.1% of the 95 subjects of this study were preterm infants, while the others were cases with a gestational age of more than 37 weeks. The mean birth weight of the neonates was 1939.15±899.2 g. The upper alarm limit of pulse oximetry (95%) had been set correctly just in almost 26% of the patients. On the other hand, only at about 21% of all the cases, a normal lower alarm limit (85%) was observed for this variable. Compliance with the normal lower and upper limits of alarm for heart rate (i.e., 90 and 180 beats/min, respectively) was reported only in 10.46% and 18.6% of the infants, respectively. This study revealed that the alarm limits in NICU for unstable neonates were frequently set outside the normal range.