From Documenting Problems to Engineering Solutions: Brenda Nyarko's Journey in Nursing Research
by Dhiroj Koirala
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Walk into a hospital's intensive care unit and you'll hear it right away: a constant stream of beeps and alarms. Some mean something urgent is happening. Most don't. Nurses hear hundreds of these sounds over a single shift, and after a while the brain starts to tune them out — a dangerous kind of sensory overload that can delay a response when a real crisis hits. It wears people down. It contributes to burnout. And it puts patients at risk.
For Brenda Nyarko, a PhD student in Nursing, none of these are theoretical. It's the question she's built her research career around: how do the systems, technologies, and everyday work environments nurses operate in shape their well-being and, in turn, the care which patients receive? "It is an important research topic," she says, with the kind of understatement that comes from having lived it.
From Bedside to Research
Before coming to UMass, Brenda spent years working as a nurse in Ghana. That work taught her something that doesn't always make it into textbooks: good care depends not just on a nurse's skill or knowledge, but on the tools put in their hands. Most of the time those tools help. Sometimes they get in the way.
Her shift toward research started during her master's program in China, where she led an integrative review on educational strategies for managing nurses' sensory overload from clinical alarms. That project surfaced a gap nobody had really addressed: the problem was well documented worldwide, but almost nothing was known about how severe it was in Ghana, or in Africa more broadly. Hospitals in resource-limited settings often run on donated or aging equipment, yet no study had ever measured how that affects nurse cognition or patient safety.
A Novel Methodological Contribution
To close that gap, Brenda designed a cross-sectional study in Ghana but ran into an immediate problem. There was no validated tool for measuring this kind of cognitive burden in her context.
Rather than build a new survey from scratch, she took a more resourceful path: she found a rigorously validated Chinese questionnaire and adapted it for English-speaking African nurses. That process was far more involved than a simple translation. She used a forward-backward translation protocol and brought in expert committees to check the instrument for cultural relevance, producing the first reliable way to measure monitoring desensitization in an under-resourced setting.
What she found was striking. Eighty percent of hospitals had no formal policy for managing clinical alerts. Nurses in neonatal and post-anesthesia units faced the highest risk. And she was able to draw a direct line between the sensory overload and burnout— specifically emotional exhaustion and depersonalization— showing that the noise wasn't just an annoyance, but a real driver of nurses leaving the profession (Nyarko et al., 2023, Australian Critical Care).
"For me, alarm fatigue is a safety issue that I saw every day as a nurse," Brenda says. "But it's not just about the noise — it's about how the design of these devices shapes the way we work and the decisions we make under pressure."
Technology isn't Brenda's only concern. Her interest in nurses' working lives runs wider than that, recognizing a broader commitment to well-being in nursing. In a multi-facility study in Ghana, she investigated workplace bullying among nurses and found that more than 85% had witnessed it, with female and junior staff bearing the brunt of it. More than a third of those targeted said the experience made them consider leaving the country to work elsewhere.
From Documenting Problems to Engineering Solutions
These days Brenda brings her understanding of nurse cognition to the Elaine Marieb Center for Nursing and Engineering Innovation (EMCNEI). Her earlier work was mostly about documenting problems while her PhD research is about engineering solutions. She's moved from surveys into human factors engineering and usability testing.
Right now her focus is on IV smart pumps— devices used to deliver medications and fluids. She's not asking whether a pump works mechanically. She's asking whether it works cognitively, for a nurse operating under pressure.
In one study, she analyzed more than five million IV pump alarms recorded over two years at a large academic medical center — the first analysis of its kind for the Baxter Sigma Spectrum pump. She found that just four alarm types accounted for over 86% of all events, and that nurses in pediatric and neonatal units faced up to 28.6 alarms per infusion, putting them at the greatest risk of sensory overload.
Her approach is deeply interdisciplinary. Alongside engineering student Marco Vital, she watches nurses at the bedside, digs through alarm data logs, and works side by side with engineers to pinpoint where a device's design is falling short. In a lab study using eye-tracking technology, she and her colleagues compared how nursing students interacted with four different IV smart pumps. The results made clear just how much interface design matters: one pump, with a touchscreen interface, produced the lowest cognitive workload and zero programming errors, while the others led to significantly more mistakes.
A Voice for Nurses, A Bridge to the Future
"Every time I look at an alarm log or watch a usability test, I picture the nurses I worked with in Ghana," Brenda says. "My research is really just an extension of bedside care. I'm trying to protect nurses and patients the same way I did when I was physically in the ward — just using a different set of tools now."
Looking forward, Brenda wants to close the distance between high-tech engineering labs and wards that are still working with limited resources. Drawing on both her clinical experience in Ghana and her usability research here, she's pushing to make sure that as hospitals adopt new digital tools, those tools end up supporting nurses — not distracting them.
Story by Dhiroj Koirala, UMass Amherst Public Writing Fellow