Abstract: Objective: To analyze eye movement behaviors of ICU nurses during visual search for abnormal data on electrocardiogram (ECG) monitors, so as to provide evidence for improving nurses' ability to identify abnormal monitoring data. Methods: From November 2024 to February 2025, 34 ICU nurses from 3 tertiary grade A hospitals in Beijing were recruited via convenience sampling. A cognitive experimental programming software and an eye tracker were adopted to record nurses' recognition performance of different types of abnormal data on ECG monitors, together with total task response time, first fixation arrival time, average fixation duration, total fixation duration and fixation count. Results: There was a statistically significant difference in ICU nurses' recognition accuracy for different types of abnormal data (P<0.05). The recognition accuracy was the lowest for abnormal blood pressure and heart rate data, with median recognition accuracy values of 68.99% and 75.62%, respectively. Statistically significant differences were also found in eye-tracking indicators across different types of abnormal data (P<0.05). Subjects in the study exhibited the shortest total fixation duration (M=11.59 s) and average fixation duration (M=8.30 s), as well as the lowest fixation count (M=75.50) for abnormal respiration data, while subjects showed the longest total fixation duration (M=37.06 s) and average fixation duration (M=15.98 s), together with the highest fixation count (M=147.50) for abnormal ECG data. Conclusion: ICU nurses have relatively poor capacity to recognize abnormal blood pressure and heart rate data. Abnormal ECG signals impose high cognitive processing difficulty. Strategies should be developed to optimize ICU nurses' attention allocation and information processing capacity for abnormal data on ECG monitors, so as to further promote nursing quality in ICU.

Key words: ECG monitor; visual search; ICU nurse; nursing quality