Signs of alarm fatigue

Investigates the cognitive-behavioural correlates of the subjective experience of 'alarm fatigue'. 


  • Cognitive Ergonomics
  • Cognitive Semiotics

In the medical world it is believed that the proliferation of alarm sounds, notably from non-actionable alarms, has the negative consequence that clinical staff gets desensitised to alarms, which may lead to inadequate responses to alarms of critical importance in caregiving. This problem, known as ‘alarm fatigue’, is currently considered a top priority among other pertinent healthcare issues by large medical institutions.

This project proposes the thesis that the problem of alarm fatigue, in its contemporary conceptualisation, is: (a) situated in a somewhat paradoxical discursive representation (being articulated too narrowly, yet too vaguely), (b) based on inferences that have not been justified with sufficiently strong evidence, and (c) neglecting the subjective dimension of the problem, although this dimension arguably could be granted ‘ontological primacy’. 

The investigation is guided by two main research questions and consists of three work packages:

Research questions

# How is alarm fatigue conceptualised in the literature, and what characterises the evolution of the narrative(s) with respect to cross referencing and critical evaluation of sources of evidence?

# What are the empirical signs of alarm fatigue and what methodological and analytical tools can adequately capture these signs and characterise them in a formalised framework?

 Work packages

 (1) A concept/discourse analysis which addresses ontological, epistemological, and methodological aspects of the problem of alarm fatigue.

 (2) A video-ethnographic study conducted at an intensive care unit, aimed at providing 1st person, 2nd person, and 3rd person perspectives on nurses’ experiences and cognitive-behavioural responses to the ICU alarm environment. 

 (3) A national survey on the experienced problem of alarm fatigue, aimed at complementing existing surveys, on which the current narrative is (partly) based. 


Technical University of Delft, The Netherlands.


Research Fellow
Michael Sonne Kristensen

Judy Edworthy, Sue Denham (Plymouth University), Elif Özcan (Technical University of Delft).

Further Reading
  • Edworthy, J (2012) Medical audible alarms: a review. J Am Med Inform Assoc ;0:1–6. doi:10.1136/amiajnl-2012-001061.
  • Edworthy, J, Hellier, E., Titchener, K, Naweed, A. & Roels, R (2011) Heterogeneity in alarm sets makes them easier to learn International Journal of Industrial Ergonomics, 41, 136-146. doi:10.1016/j.ergon.2010.12.004
  • Hutchins, E. (2010). Cognitive Ecology. Topics in Cognitive Science, 2(4), 705–7015. doi:10.1111/j.1756-8765.2010.01089.x
  • Lahlou, S. (2011). How can we capture the subject’s perspective? An evidence-based approach for the social scientist. Social Science Information, 50(3-4), 607–655. doi: 10.1177/0539018411411033
  • Seagull, F. J., & Sanderson, P. M. (2001). Anesthesia alarms in context: An observational study. Human Factors: The Journal of the Human Factors and Ergonomics Society, 43(1), 66–78. doi:10.1518/001872001775992453
  • Zlatev, J. (2012). Cognitive semiotics: An emerging field for the transdisciplinary study of meaning. The Public Journal of Semiotics, 4(1), 2–24.