{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T02:06:06Z","timestamp":1784167566513,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72471006"],"award-info":[{"award-number":["72471006"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["7207100"],"award-info":[{"award-number":["7207100"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Most modern electrocardiographic (ECG) monitors include visual alarm cues to flag abnormalities. Whether these cues consistently improve nurses' recognition of abnormal data remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The primary aim is to examine the effects of alarm cues on ICU nurses' behavioural performance when identifying abnormal physiological parameters while using bedside vital\u2010sign monitors. The secondary aim was to investigate how alarm cues influence nurses' visual attention patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>A within\u2010subjects experiment with ICU nurses using a simulated monitor under two conditions (with vs. without alarm cues). Behavioural and eye\u2010tracking metrics were recorded across heart rate, blood pressure, oxygen saturation, respiration and ECG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010four ICU nurses between October 2024 and January 2025 completed the experiment. Alarm cues statistically significantly shortened reaction time (449.86\u2009\u00b1\u2009134.67\u2009s vs. 408.57\u2009\u00b1\u2009140.41\u2009s;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025). Changes in accuracy were selective: identification of abnormal ECG statistically significantly improved (median: 93% vs. 86%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012), whereas accuracy for abnormal respiration statistically significantly decreased (mean: 78% vs. 88%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). No statistically significant differences were observed for heart rate, blood pressure or oxygen saturation. Eye\u2010tracking results showed that attention was drawn to cued regions, with statistically significantly longer fixation durations (ECG: 44.42\u2009\u00b1\u200927.51\u2009s vs. 33.98\u2009\u00b1\u200925.27\u2009s,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004; blood pressure: median 27.66 vs. 20.41\u2009s,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025) and statistically significantly fewer visits to uncued areas (105.94\u2009\u00b1\u200934.87 vs. 89.82\u2009\u00b1\u200935.51,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), indicating a more focused but less comprehensive search.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Visual alarm cues on ICU monitoring interfaces can effectively enhance attentional focus and accelerate decision\u2010making but do not uniformly improve recognition accuracy across physiological parameters. These results highlight the need for optimising alarm interface design to balance efficiency and situational awareness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Alarm systems should be parameter\u2010specific and adaptive, adjusting cue salience to data context to minimise attentional tunnelling. Co\u2010locating cues with the corresponding numeric\/waveform fields and using graded, multi\u2010layered indicators (rather than a single global alert) can support rapid yet comprehensive scanning. Brief scan\u2010path prompts or training that requires verification of non\u2010cued parameters may mitigate missed abnormalities. These strategies can help nurses sustain fast responses without sacrificing holistic monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70342","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T15:50:01Z","timestamp":1767887401000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Do Alarm Cues on\n                    <scp>ECG<\/scp>\n                    Monitors Enhance\n                    <scp>ICU<\/scp>\n                    Nurses' Detection of Abnormal Data? Evidence From an Eye\u2010Tracking Experiment"],"prefix":"10.1111","volume":"31","author":[{"given":"Shumei","family":"Zhang","sequence":"first","affiliation":[{"name":"Intensive Care Unit Cancer Hospital Chinese Academy of Medical Science  Beijing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiling","family":"Hu","sequence":"additional","affiliation":[{"name":"School of Nursing Peking University  Beijing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Ge","sequence":"additional","affiliation":[{"name":"School of Nursing Peking University  Beijing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiashuai","family":"Li","sequence":"additional","affiliation":[{"name":"School of Nursing Peking University  Beijing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Feng","sequence":"additional","affiliation":[{"name":"School of Nursing Peking University  Beijing PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7407-5257","authenticated-orcid":false,"given":"Xue","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Nursing Peking University  Beijing PR 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