Sleep Fragmentation and Intravenous Alarm Fatigue Among Night-Shift Nurses in High-Dependency Units

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Published: 2026-02-15
DOI: https://doi.org/10.61919/p5qpb545
Keywords:
Alarm Fatigue; Circadian Rhythm; High-Dependency Unit; Infusion Pumps; Night-Shift Work; Occupational Fatigue; Psychomotor Vigilance; Sleep Quality.

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Fouzia Pervaiz
Nursing Officer, PAEC General Hospital, Islamabad, Pakistan
Zarina Naz
MHPE Scholar, National University of Medical Sciences, Rawalpindi, Pakistan
Kanwal Mazhar
Charge Nurse, Nishtar Hospital, Multan, Pakistan
Humaira Iqbal
Charge Nurse, Chaudhry Pervaiz Elahi Institute of Cardiology, Multan, Pakistan
Mohammad Talha Khalid
Nursing Instructor, The Next College of Nursing, Multan, Pakistan
Shaikh Khalid Muhammad
Professor of Medicine, CMC Teaching Hospital, SMBBMU, Larkana, Pakistan

Abstract

Background: Frequent intravenous infusion-pump alarms may increase sensory workload among night-shift nurses, but their relationships with sleep quality, occupational fatigue, and psychomotor vigilance remain insufficiently characterized. Objective: To examine the associations between intravenous alarm frequency, sleep disruption, occupational fatigue, and cognitive alertness among night-shift nurses working in high-dependency units. Methods: This cross-sectional study was conducted from October 2025 to January 2026 in tertiary-care high-dependency units in Punjab, Pakistan. Eighty-four nurses completed the Pittsburgh Sleep Quality Index, Fatigue Assessment Scale, an alarm-fatigue visual analogue scale, shift diaries, and pre-shift and post-shift Psychomotor Vigilance Tasks. Pearson correlations and paired-samples t-tests were applied. Results: Participants encountered 64.2 ± 14.8 alarms per shift and had a mean global Pittsburgh Sleep Quality Index score of 12.6 ± 3.1. Alarm frequency correlated with sleep-quality scores (r = 0.68), fatigue scores (r = 0.72), and post-shift attention lapses (r = 0.61; all p < 0.001). Reaction time increased from 242.4 ± 18.5 to 318.9 ± 34.2 ms, with a mean difference of 76.5 ms (95% CI, 68.2–84.8; p < 0.001). Attention lapses increased from 1.8 ± 0.9 to 6.4 ± 2.3, with a mean difference of 4.6 (95% CI, 4.06–5.14; p < 0.001). Conclusion: Greater intravenous alarm exposure was associated with poorer sleep, greater fatigue, and reduced post-shift vigilance, although causal relationships cannot be inferred

Article Details

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Vol. 4 No. 3 (2026)

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Articles
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This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

1.
Fouzia Pervaiz, Zarina Naz, Kanwal Mazhar, Humaira Iqbal, Mohammad Talha Khalid, Shaikh Khalid Muhammad. Sleep Fragmentation and Intravenous Alarm Fatigue Among Night-Shift Nurses in High-Dependency Units. JHWCR [Internet]. 2026 Feb. 15 [cited 2026 Aug. 16];4(3):1-6. Available from: https://jhwcr.com/index.php/jhwcr/article/view/2017

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