Jungmi Kwon, Y A Kim
Background/Objectives: Alarm fatigue is common in clinical settings and can impair nursing performance. Guided by the job demands–resources framework, this cross-sectional study examined the associations among alarm fatigue, nursing performance, perceived stress, and patient safety culture, including an indirect association through perceived stress and moderation by patient safety culture. Methods: Self-report questionnaires completed by 218 registered nurses from two general hospitals in South Korea were used to assess alarm fatigue, perceived stress, patient safety culture, and nursing performance. Data were analyzed using descriptive statistics, Pearson’s correlations, and Hayes’ PROCESS macro with 5000 bootstrap samples controlling for covariates. Results: Alarm fatigue was positively correlated with perceived stress and negatively correlated with nursing performance. Patient safety culture was positively correlated with nursing performance. Alarm fatigue was positively associated with perceived stress, and perceived stress was negatively associated with nursing performance. The indirect association through perceived stress was significant. Patient safety culture moderated the association between perceived stress and nursing performance. The index of the moderated indirect association was significant. Conclusions: These findings suggest that alarm-related problems should be addressed in clinical and assistive nursing practice by integrating strategies aimed at reducing unnecessary alarms, strengthening training in alarm prioritization and interruption management, supporting nurses’ stress responses, and promoting a patient safety culture characterized by open communication and teamwork. Considering the cross-sectional design of this study, the findings should be interpreted as associations, rather than causal evidence.