Associations between alarm fatigue and burnout dimensions among intensive care unit nurses: a systematic review and meta-analysis
Abstract
BackgroundTo systematically evaluate the strength of the associations between alarm fatigue and overall and dimensional burnout among intensive care unit (ICU) nurses, and to explore potential sources of heterogeneity.MethodsPubMed, CINAHL, Embase, Web of Science, the Cochrane Library, PsycINFO and the Chinese databases CNKI, Wanfang, VIP and SinoMed were systematically searched from inception to August 2026. Cross-sectional studies reporting correlation coefficients between alarm fatigue and burnout were included. Methodological quality was appraised with the revised JBI critical appraisal tool for analytical cross-sectional studies. Effect sizes were pooled with a random-effects model after Fisher z transformation, with Hartung–Knapp-adjusted confidence intervals and tests for pooled effects; subgroup, sensitivity and publication bias analyses were performed.ResultsFourteen cross-sectional studies were included, of which 12 entered quantitative synthesis. Alarm fatigue was moderately positively correlated with overall burnout (r = 0.436, 95% CI 0.288–0.564, I2 = 89.7%), and was correlated with emotional exhaustion (r = 0.474, 95% CI 0.132–0.715), depersonalization (r = 0.365, 95% CI 0.092–0.587) and personal accomplishment (r = −0.277, 95% CI − 0.463 to −0.067). Substantial heterogeneity was observed in the dimensional analyses (I2 = 87.5–93.3%), and the prediction intervals crossed zero for all three dimensions. Thus, the strength of these associations may vary across study populations and clinical settings. Exploratory subgroup analysis showed a larger pooled effect in Chinese studies than in Middle Eastern studies (r = 0.521 vs. 0.285, p = 0.0014). Sensitivity analyses yielded directionally consistent results, but publication bias could not be reliably assessed because fewer than 10 studies were included in each analysis.Conclusion and recommendationsBased on cross-sectional evidence, among ICU nurses, alarm fatigue is positively associated with emotional exhaustion and depersonalization and negatively associated with personal accomplishment. These findings do not establish that reducing alarm fatigue will reduce burnout; longitudinal studies are needed to establish the causal direction, together with intervention studies addressing alarm management strategies.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, Identifier [CRD420261492716].
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BibTeX
@article{su2026associations,
title = {{Associations between alarm fatigue and burnout dimensions among intensive care unit nurses: a systematic review and meta-analysis}},
author = {Gangping Su and Yixian Ma and Xiaofei Kang and Feng Zhuo and Min Ding},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.2004645},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.2004645},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Associations between alarm fatigue and burnout dimensions among intensive care unit nurses: a systematic review and meta-analysis
AU - Gangping Su
AU - Yixian Ma
AU - Xiaofei Kang
AU - Feng Zhuo
AU - Min Ding
PY - 2026
DA - 2026/10/30
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.2004645
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.2004645
AB - BackgroundTo systematically evaluate the strength of the associations between alarm fatigue and overall and dimensional burnout among intensive care unit (ICU) nurses, and to explore potential sources of heterogeneity.MethodsPubMed, CINAHL, Embase, Web of Science, the Cochrane Library, PsycINFO and the Chinese databases CNKI, Wanfang, VIP and SinoMed were systematically searched from inception to August 2026. Cross-sectional studies reporting correlation coefficients between alarm fatigue and burnout were included. Methodological quality was appraised with the revised JBI critical appraisal tool for analytical cross-sectional studies. Effect sizes were pooled with a random-effects model after Fisher z transformation, with Hartung–Knapp-adjusted confidence intervals and tests for pooled effects; subgroup, sensitivity and publication bias analyses were performed.ResultsFourteen cross-sectional studies were included, of which 12 entered quantitative synthesis. Alarm fatigue was moderately positively correlated with overall burnout (r = 0.436, 95% CI 0.288–0.564, I2 = 89.7%), and was correlated with emotional exhaustion (r = 0.474, 95% CI 0.132–0.715), depersonalization (r = 0.365, 95% CI 0.092–0.587) and personal accomplishment (r = −0.277, 95% CI − 0.463 to −0.067). Substantial heterogeneity was observed in the dimensional analyses (I2 = 87.5–93.3%), and the prediction intervals crossed zero for all three dimensions. Thus, the strength of these associations may vary across study populations and clinical settings. Exploratory subgroup analysis showed a larger pooled effect in Chinese studies than in Middle Eastern studies (r = 0.521 vs. 0.285, p = 0.0014). Sensitivity analyses yielded directionally consistent results, but publication bias could not be reliably assessed because fewer than 10 studies were included in each analysis.Conclusion and recommendationsBased on cross-sectional evidence, among ICU nurses, alarm fatigue is positively associated with emotional exhaustion and depersonalization and negatively associated with personal accomplishment. These findings do not establish that reducing alarm fatigue will reduce burnout; longitudinal studies are needed to establish the causal direction, together with intervention studies addressing alarm management strategies.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, Identifier [CRD420261492716].
SN - 2296-2565
ER -