Discussion: Descriptive Qualitative Study
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Site A has a virtual electronic ICU (eICU), which provides 24-hour surveillance by physicians and nurses of critically ill patients via cameras and physiologic data streams across the 4 states the health care system serves. Site B is a 183-bed urban maternity and pediatric teach- ing hospital in the Western area of the United States with over 2400 births.Both sites have new maternity units (built in 2013 and 2015, respec- tively) equipped with the latest monitoring tech- nology. Sites A and B have different vendors for their EFM surveillance system. Site B was in- cluded to explore any possible variances in par- ticipant responses based on EFM system vendor since alarm parameters differ by vendor.
The inclusion criterion for participants was currently practicing as a staff nurse on their spe- cialty unit. Staff nurses in the adult ICU, NICU, and labor and birth units were recruited to par- ticipate via an e-mail from their nurse manager explaining the purpose of the study, its voluntary nature, details of their potential participation, and date, time, and location of the focus groups.
The first 10 nurses on each unit who responded to the e-mail and agreed to participate were given information that they were confirmed as partic- ipants. An e-mail reminder was sent the day be- fore focus groups to confirmed participants. In- stitutional review board approval was obtained at each site.
Design and data collection This was a descriptive qualitative study con- ducted using focus groups. Discussions followed a semistructured guide (Supplemental Digital Content, Table 1, available at: http://links.lww. com/JNCQ/A436) and were held at the 2 sites. After obtaining written informed consent and confirming inclusion criterion, nurses in each of the focus groups were asked about what types of alerts and alarms are common in their clini- cal setting, if they were helpful, if they presented challenges, and suggestions for improvement. Two experienced nurse scientists with expertise in patient safety, qualitative research methodol- ogy, and clinical backgrounds in labor and birth developed the questions based on their exper- tise, review of alarm and alert literature, and re- view of EFM vendor alarm parameters. Focus groups lasted 90 minutes each. Discussions were tape-recorded and professionally transcribed verbatim, and transcripts were cross-checked against recordings for accuracy. Field notes were taken.
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