Health service organizations use physiological monitoring systems with the aim of monitoring changes in the patient’s status. These systems provide basic information to clinicians to assess the patient and make appropriate treatment decisions [1]. These systems, called clinical alarms, warn health employees when there is a situation threatening the health of the patient and requiring emergency assistance; hence, they contribute to increasing patient safety [2]. However, excessive numbers of inoperative and false alarm signals from medical devices cause alarm fatigue [3].

Alarm fatigue, which is described as a public health problem that negatively affects patient safety and is increasing on a global scale [4], is explained as a situation of physical fatigue and sensory overload, weariness, unwillingness to hear, and, after a while, exhaustion, accompanied by desensitization as a result of long-duration exposure to high volume and excessive numbers of alarms [5]. A recent study comprehensively examining the definitions, influencing factors, and mitigation strategies for alarm fatigue in healthcare settings reported that alarm fatigue results in poor performance, disorientation and distraction, increased blood pressure, burnout, sleep disturbances, and ear fatigue in healthcare professionals. The same study listed the consequences of alarm fatigue for patients as interrupted communication, disrupted sleep, and overlooked signs of instability that can lead to serious harm, including death [6].

The emergency department is identified as an environment with a high risk of alarm fatigue due to the high number of alarms in a stressful environment involving high-sudden, time-critical tasks and conditions [7]. A study conducted at an academic ED in Finland reported that 28,000 alarms were detected in monitoring units over one month [8]. A multicenter, mixed-method study examining the frequency and pattern of emergency department monitor alarms, staff experiences with alarms, and alarm fatigue reported that 396,011 alarms over two months had become an integral part of the emergency department. The same study concluded that emergency department personnel operate in an alarm environment prone to alarm fatigue, with unclear indications for monitoring, unclear alarm responsibility, high workload, and a physical environment that increases alarm volume and ambient noise [7]. In a recent cross-sectional study conducted with emergency room nurses, it was observed that as the level of knowledge of emergency room nurses increased, the perceived barriers to alarm management decreased and their alarm management practices improved [9].

It is essential for maintaining physical and mental health, cognitive functions, and overall quality of life. Therefore, quality sleep is crucial for nurses working in high-stress environments such as emergency departments. Poor quality sleep can affect nurses' health and well-being. It can also impair cognitive functions such as memory, attention, and decision-making, which are critical to the fast-paced and often high-risk environment of the emergency department, thus negatively impacting patient care and safety [10]. A study examining alarm fatigue and sleep quality in healthcare workers reported that healthcare workers experience alarm fatigue, which can reduce sleep quality [11]. However, no study has been found examining the effect of sleep quality on alarm fatigue in emergency nurses. Insufficient or disrupted sleep can reduce individuals' ability to cope with stress in their daily lives and, consequently, lead to alarm fatigue. In this context, better understanding the effects of sleep quality on alarm fatigue is vital for both improving individuals' overall health and quality of life and reducing serious risks to patient safety. In this context, this study examined the impact of sleep quality on alarm fatigue in emergency nurses.