Table 2 The major topics and sub themes with participant counts, percentages and examples. N = 120

Alarms

Alarm limit set up

Participant #14: Alarm-limits are set differently by different people - > either the monitor then alerts very quickly or not at all for long.

(22 participants, 18.3%)

False alarms

Participant #9: There are too many false alarms that have no relevance. The ideal would be: If there is no message displayed on the monitor, everything is fine.

(18 participants, 15%)

Alarm fatigue

Participant #48: Frequent false alarms lead to ignoring of alarms.

(12 participants, 10%)

Default settings

Participant #71: Impractical default alarm-limits.

(10 participants 8.3%)

Artifacts

16 participants (13.3%)

Participant #12: SpO2 artifacts. Artifacts of the ECG caused by improper positioning of the electrodes.

Participant #66: Cautery artifacts on the ECG.

Participant #107: Distinguish artifacts from reality.

Software

Information presentation

Participant #49: Much visual and auditory information, the sense for the relevant gets lost.

(41 participants, 34.2%)

Participant #102: For a comprehensive state assessment, the gaze must travel across multiple monitors and numbers, which must then be interpreted.

Interface design

Participant #47: Too many clicks needed to configure the monitor. Great tools hidden in submenus, so they are hard to find.

(17 participants, 14.2%)

Participant #71: In unfamiliar monitors, the patient is effectively worse off due as the vital-signs are perceived much worse and slower.

Intuitiveness

Participant #23: The screen layout should be easily adjustable (intuitive as Apple products).

(11 participants, 9.2%)

Participant #98: Operation is non-intuitive.

Hardware

Cables

Participant #23: Wireless would be interesting. A wish: a single device on the patient, which measures all vital signs.

(29 participants, 24.2%)

Participant #106: Always cable-clutter.

Participant #108: Cable disconnected / incorrect values measured.

Size/weight

Participants #41: Sometimes difficult to transport, smaller transport monitors would be better.

(24 participants, 20%)

Participants #63: Not robust enough for the everyday run (much wear material).

Participant #110: Patient monitoring is too heavy (kg).

Display

Participant #36: Small display with reduced resolution. Touchscreen would probably be better or above all more intuitive.

(10 participants, 8.3%)

Participant #46: Numbers too small, not visible from a distance.

Components

Participant #63: Not robust enough for the everyday run (much wear material).

(9 participants, 7.5%)

Participant #74: loose contacts...

Participant #98: Unreliable battery life.

Human factors

Human performance

Participant #82: One pays too little attention to the monitor.

Participant #82: Although a pathological value is on the monitor, the user does not recognize it because a number is not readily perceptible.

(15 participants, 12.5%)

Participant #95: Tired: One has to look several times until the information arrives.

Familiarization effects

Participant #13: When changing the hospital or the monitor type, it takes a long time (up to many days) to get used to the new monitors.

(6 participants, 5%)

System factors

Lack of standardization

Participant #23: Presentation / standard alarm-limits not uniform.

(8 participants, 6.7%)

Work environment

Participant #97: Lighting conditions and viewing angle to the monitor.

(7 participants, 5.8%)

Participant #114: A relatively large area with different displays that one must monitor continuously.

Comments/Suggestions

26 participants (21%)

Participant #54: Measured values for non-continuous data collection (e.g., blood pressure) should disappear after a specific time (e.g., 3 or 5 min).

Participant #116: In emergency situations, one must get a quick and safe overview, which is not always possible with the current monitoring.