Alarm Management Competence in Clinical Nursing Practice: An Evolutionary Concept Analysis.

AIMS: To clarify the defining attributes, antecedents, and consequences of alarm management competence in clinical nursing practice and to develop a conceptual definition and framework. BACKGROUND: Clinical alarms are integral to patient monitoring, yet effective alarm management requires more than technical device operation. Alarm-related knowledge, skills, judgment, behaviors, and fatigue have been examined across the literature, but the concept of alarm management competence remains insufficiently defined. EVALUATION: Rodgers' evolutionary concept analysis was conducted. PubMed, CINAHL, Embase, Scopus, and Web of Science were searched from inception to August 2026, supplemented by searches of relevant professional-organization websites and citation searching. A total of 28 sources were included. KEY ISSUES: Seven defining attributes were synthesized: foundational clinical knowledge for alarm management, alarm perception and discrimination, clinical decision-making, technical skills for alarm equipment operation, interprofessional collaboration and communication, alarm fatigue resilience, and professional development capacity. Six antecedents and three domains of potential consequences were identified. These findings were integrated into a conceptual definition and framework of alarm management competence. CONCLUSION: Alarm management competence is a dynamic, multidimensional clinical nursing competence that extends beyond alarm-related knowledge or device operation and integrates cognitive, perceptual, technical, collaborative, resilience-related, and developmental dimensions. IMPLICATIONS FOR NURSING MANAGEMENT: The conceptual framework can inform competency development, education, alarm governance, and organizational support for nurses' alarm management practice. REPORTING METHOD: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. PATIENT OR PUBLIC CONTRIBUTION: Not applicable.