Are melodic medical equipment alarms easily learned?
BACKGROUND
We tested melodic auditory alarms recommended in the IEC 60601-1-8 standard for medical electrical equipment for ease of learning and discrimination, and for effectiveness during a timeshared task.


METHODS
Twenty-two critical care nurses learned the IEC 60601-1-8 melodic alarms over two training sessions more than a week apart, with or without mnemonics suggested in the standard. Subsequently, the nurses identified alarms arriving at quasi random intervals while performing a timeshared arithmetic task.


RESULTS
Only one nurse (4.5%) identified the alarms with 100% accuracy after two training sessions. Mnemonics did not improve overall alarm identification accuracy (mnemonic = 56%, nonmnemonic = 55%) but led to a narrower range of confusions between alarms. Nurses responded faster (P < 0.0001) and more accurately (P = 0.032) to medium priority than high priority alarms, despite rating high priority alarms as sounding more urgent (P < 0.0001). Nurses with at least 1 yr of formal musical training identified the alarms much more accurately (musical training = 73%, no musical training = 38%, P < 0.0001), perceived a greater distinction between high and medium priority alarms (P = 0.002), and found identifying the alarms easier overall (P = 0.023). During the timeshared task, nurses' responses were slower (P = 0.002) and became less accurate (P = 0.02).


CONCLUSIONS
The slow rate of learning and persistent confusions suggest that the IEC 60601-1-8 melodic alarms should be redesigned before they are adopted for clinical practice.
Wee
Alexandra N
AN
School of Information Technology Electrical Engineering, University of Queensland, St. Lucia, Queensland, Australia.
Sanderson
Penelope M
PM
D000161:Acoustic Stimulation / Q000379:methods*; D000328:Adult; D003422:Critical Care / Q000379:methods; D004193:Discrimination Learning / Q000502:physiology; D004389:Durable Medical Equipment / Q000592:standards; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009146:Music; D009740:Nursing Staff / Q000592:standards; D011897:Random Allocation; D011930:Reaction Time / Q000502:physiology; D013997:Time Factors