Ventilator Alarm Fatigue among Respiratory Therapists in Saudi Arabia: A Cross-Sectional Study

Abstract

Background: Alarm fatigue—a state of sensory overload leading to desensitization toward clinical alarms—is increasingly recognized as a patient safety hazard in intensive care settings. Respiratory therapists (RTs) bear primary responsibility for managing ventilator alarms yet remain understudied with respect to alarm fatigue in the Saudi Arabian context.

Objectives: To quantify the prevalence and severity of ventilator alarm fatigue among RTs practicing in Saudi Arabian hospitals, identify associated occupational and organizational factors, and assess its impact on alarm response behaviors.

Methods: A cross-sectional survey was conducted between January and April 2024 across 14 hospitals in three Saudi regions (Riyadh, Jeddah, Dammam). A validated 28-item Ventilator Alarm Fatigue Scale (VAFS) and structured questions on alarm exposure and response were administered to 312 eligible RTs. Descriptive statistics, one-way ANOVA, Pearson correlation, and multivariate logistic regression were performed using SPSS v28.

Results: The overall mean alarm fatigue score was 71.3 ± 14.7 (scale 0–100). High alarm fatigue (score ≥75) was present in 24.7% (n = 77) of participants, moderate fatigue (60–74) in 46.5% (n = 145), and low fatigue (<60) in 28.8% (n = 90). Alarm frequency >200/shift, night-shift assignment, ICU setting, tertiary hospital affiliation, and absence of alarm management training were independently associated with high alarm fatigue (all p < 0.05). A significant positive correlation was found between alarms per shift and fatigue score (r = 0.512, p < 0.001). RTs with high fatigue were significantly more likely to silence alarms without patient assessment (36.2% vs. 8.4%; p < 0.001).

Conclusions: Ventilator alarm fatigue is highly prevalent among Saudi RTs and is associated with potentially unsafe alarm response behaviors. Targeted interventions including alarm customization protocols, staffing optimization, and structured training programs are urgently needed.