{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:01:33Z","timestamp":1790060493644,"version":"4.0.1"},"reference-count":69,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"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":["72271172"],"award-info":[{"award-number":["72271172"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013139","name":"Humanities and Social Science Fund of Ministry of Education of China","doi-asserted-by":"publisher","award":["21YJC630142"],"award-info":[{"award-number":["21YJC630142"]}],"id":[{"id":"10.13039\/501100013139","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2026JDKP0091"],"award-info":[{"award-number":["2026JDKP0091"]}],"id":[{"id":"10.13039\/501100004829","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":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Alarm fatigue is a critical concern in intensive care units (ICUs), affecting nurse well\u2010being and patient safety. It may reflect interacting conditions within the clinical work system, yet evidence on its severity and associated factors among ICU nurses remains fragmented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To synthesise evidence on alarm fatigue severity and associated factors among ICU nurses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Eleven databases were searched from inception to July 2025. Observational studies assessing alarm fatigue among ICU nurses using measurement tools with reported reliability were included. A random\u2010effects meta\u2010analysis was performed for alarm fatigue severity, stratified by instrument; associated factors and adverse outcomes were synthesised narratively using direction\u2010of\u2010association plots.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 28 studies involving 6908 ICU nurses were included, of which 27 reported alarm fatigue scores. For the Iranian Alarm Fatigue Questionnaire, the most common instrument, the pooled mean was 26.12 (95% CI: 23.94\u201328.30). Heterogeneity was extremely high (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u224898%) and was not meaningfully explained by subgroup analyses or meta\u2010regression. Directional evidence suggested that higher alarm fatigue was associated with a greater tendency towards medical errors and higher levels of burnout. Evidence on associated factors was mostly inconsistent or non\u2010significant, with studies focusing mainly on person\u2010 and organisation\u2010level factors. Poorer health, secondary traumatic stress, false alarms and lower trust in alarms tended to show adverse directional signals, whereas job satisfaction, resilience, alarm management support and a better nursing work environment showed potentially protective signals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Alarm fatigue among ICU nurses appeared to show a moderate tendency overall, although findings should be interpreted cautiously because of substantial heterogeneity. Evidence on associated factors remains scattered, with task\u2010, technology\u2010 and environment\u2010related factors comparatively underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Alarm fatigue may be usefully considered from a clinical work\u2010system perspective. Greater attention to task, technology and environmental factors may inform future practice improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review\u00a0Registration<\/jats:title>\n                    <jats:p>Prospero registration number: CRD42024565806.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70666","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:39:37Z","timestamp":1788421177000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severity and Associated Factors of Alarm Fatigue Among Intensive Care Unit Nurses: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"31","author":[{"given":"Ling","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University  Chengdu People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siying","family":"Wei","sequence":"additional","affiliation":[{"name":"West China Hospital\/West China School of Nursing Sichuan University  Chengdu People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawen","family":"An","sequence":"additional","affiliation":[{"name":"West China Hospital\/West China School of Nursing Sichuan University  Chengdu People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjun","family":"Hu","sequence":"additional","affiliation":[{"name":"West China Hospital\/West China School of Nursing Sichuan University  Chengdu People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7484-847X","authenticated-orcid":false,"given":"Xiaofeng","family":"Xie","sequence":"additional","affiliation":[{"name":"West China Hospital\/West China School of Nursing Sichuan University  Chengdu People's Republic of China"},{"name":"Innovation Center of Nursing Research Nursing Key Laboratory of Sichuan Province  Chengdu People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"e_1_2_16_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-025-03369-2"},{"key":"e_1_2_16_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12969"},{"key":"e_1_2_16_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2006.01.002"},{"key":"e_1_2_16_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.6032"},{"key":"e_1_2_16_6_1","first-page":"1","volume-title":"Patient Safety Watch","author":"NSW Clinical Excellence Commission","year":"2024"},{"key":"e_1_2_16_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjoq-2023-002342"},{"key":"e_1_2_16_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15555"},{"key":"e_1_2_16_9_1","unstructured":"\u201cTop 10 Health Technology Hazards for 2020 \u201dhttps:\/\/www.ecri.org.uk\/top\u201010\u2010health\u2010technology\u2010hazards\u20102020\/."},{"key":"e_1_2_16_10_1","unstructured":"\u201cCritical Access Hospital: 2025 National Patient Safety Goals \u201dhttps:\/\/www.jointcommission.org\/standards\/national\u2010patient\u2010safety\u2010goals\/."},{"key":"e_1_2_16_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/23779608231207227"},{"key":"e_1_2_16_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/qshc.2005.015842"},{"key":"e_1_2_16_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_16_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-024-02082-w"},{"key":"e_1_2_16_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2021.103973"},{"key":"e_1_2_16_16_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Deeks J. 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