Introduction: Alarm fatigue and medical alarm mismanagement reduces the quality of patient care and creates stressful work environments for clinicians. Here, the feasibility of a novel “prealarm” system that utilizes multisensory integration of auditory and haptic stimuli is examined as a possible solution. Methods: Three vital signs (heart rate, blood pressure, and blood oxygenation) were represented by three musically distinct sounds that were combined into soundscapes and progressed through five pre-alarm zones (very low to very high). Three haptic conditions were tested with the auditory stimulus to determine the best combination of auditory and haptic stimulation. Qualitative data was collected through surveys and the NASA TLX index Results: Alterations in frequency and timbre were most effective at transmitting information regarding changing vital sign zones with comparatively higher accuracy and quicker reaction time (RT), p < .01. The addition of haptic stimuli to the auditory soundscape caused no significant decline in study participant accuracy or RT. However, two weeks after training, participants performed the tasks significantly faster ( p < .001) and felt the alarm monitoring task was significantly less cognitively demanding ( p < .01), compared to the unisensory condition. Participants also felt more confident in identifying changing vital signs with the addition of haptic stimuli. Discussion: The current study demonstrates that multisensory signals do not diminish the perception of transmitted information and suggest efficient training benefits over unimodal signals. Multisensory training may be beneficial over time compared to unisensory training due to a stronger consolidation effect. The potential integration of haptic input with existing auditory alarm systems and training is supported.

An estimated 70% of patients who have been in the Intensive Care Unit (ICU) experience some form of Post-Intensive Care Syndrome (PICS). As a stressful environment, the ICU can be traumatic for any patient; however, the disruption of sleep experienced by patients in ICU negatively impacts their mental status and recovery. One of the most significant contributors to sleep disruption is the constant blare of monitor alarms, many of which are false or redundant. Through multisensory approaches and procedural redesign, the hostile acoustic environment of the ICU that causes so many to suffer from PICS may be alleviated. In this paper, we present suggestions for improving the ICU acoustic environment to possibly reduce the incidence of post-ICU complications such as PICS.

Alarm fatigue is an issue for healthcare providers in the intensive care unit, and may result from desensitization of overbearing and under-informing alarms. To directly increase the overall identification of medical alarms and potentially contribute to a downstream decrease in the prevalence of alarm fatigue, we propose advancing alarm sonification by combining auditory and tactile stimuli to create a multisensory alarm. Participants completed four trials-two multisensory (auditory and tactile) and two unisensory (auditory). Analysis compared the unisensory trials to the multisensory trials based on the percentage of correctly identified point of change, direction of change and identity of three physiological parameters (indicated by different instruments): heart rate (drums), blood pressure (piano), blood oxygenation (guitar). A repeated-measures of ANOVA yielded a significant improvement in performance for the multisensory group compared to the unisensory group (p < 0.05). Specifically, the multisensory group had better performance in correctly identifying parameter (p < 0.05) and point of change (p < 0.05) compared to the unisensory group. Participants demonstrated a higher accuracy of identification with the use of multisensory alarms. Therefore, multisensory alarms may relieve the auditory burden of the medical environment and increase the overall quality of care and patient safety.