scholarly journals Common problems with current industry standard patient monitoring: a mixed qualitative and quantitative study

2019 ◽  
Author(s):  
David Tscholl ◽  
Lucas Handschin ◽  
Julian Rössler ◽  
Mona Weiss ◽  
Donat R. Spahn ◽  
...  
Keyword(s):  
Patient Monitoring ◽  
Human Performance ◽  
Information Overload ◽  
Rating Scale ◽  
Major Theme ◽  
Qualitative And Quantitative ◽  
Industry Standard ◽  
Standard Patient ◽  
Parametric Testing ◽  
Qualitative And Quantitative Study

Abstract BACKGROUND: Patient monitoring ensures the safety of patients in perioperative, intensive care and emergency medicine. There are some well-studied issues, such as alarm fatigue and information presentation. For this study, we use a mixed qualitative and quantitative approach to get a global feel for the problems of users with today's state of the art patient monitoring. METHODS: First, we conducted interviews with 120 anesthesiologists (physicians and nurses) asking them about problems they experience with patient monitors. We then coded the answers into topics and subtopics that we present and discuss. In a second study, a field survey with 25 anesthesiologists, we added a quantitative part in which anesthesiologists rated their agree- or disagreement with statements based on the themes identified in the prior analysis on a five-step ordinal rating scale. RESULTS: We have identified the following six main topics: 1. "Alarms," 2. "Artifacts," 3. "Software," 4. "Hardware," 5. "Human Factors," 6. "System Factors," and a total of 17 sub-topics. The quantitative statements raised for each major theme were: 1. “problems with alarm settings complicate the work with patient monitoring.” (96% agreed) 2. “artifacts complicate the assessment of the patient's condition.” (56% agreed) 3. “information overload makes it difficult to get a quick overview of the situation.” (56% agreed) 4. “problems with cables make working with patient monitors tedious.” (88% agreed) 5. “factors related to human performance lead to patient conditions not being perceived on the monitor.” (64% agreed) 6. “Insufficient standardization: Switching back and forth between monitors from different manufacturers makes it difficult to work with patient monitors.” (88% agreed). Non-parametric testing determined all six statements to differ significantly from the neutral opinion. CONCLUSION: This study provides an overview of the problems users face in their work with patient monitoring. The most annoying issues identified were related to alarms, cables and insufficient standardization between different manufacturers. An ideal monitor should, therefore, have an alarm system that reduces false positive alarms to a minimum, works with as few cables as possible and is easy to learn. This paper shows that there is still much room for improvement in patient monitoring systems.

scholarly journals It’s not you, it’s the design - common problems with patient monitoring reported by anesthesiologists: a mixed qualitative and quantitative study.

2019 ◽  
Author(s):  
David Tscholl ◽  
Lucas Handschin ◽  
Julian Rössler ◽  
Mona Weiss ◽  
Donat R. Spahn ◽  
...  
Keyword(s):  
Human Factors ◽  
Quantitative Study ◽  
Patient Monitoring ◽  
Information Overload ◽  
Major Theme ◽  
Monitoring Methods ◽  
Qualitative And Quantitative ◽  
Therapeutic Decisions ◽  
Common Problems ◽  
Qualitative And Quantitative Study

Abstract BACKGROUND Patient monitoring is critical for perioperative patient safety as anesthesiologists routinely make crucial therapeutic decisions of the information displayed on patient monitors. Research has shown that today's patient monitoring provides room for improvement regarding known issues such as information overload and alarm fatigue. The rationale for this study was to learn more about the problems anesthesiologists face with patient monitors and to provide improvement suggestions for next-generation patient monitoring. METHODS We conducted a two-center qualitative and quantitative study. First, we interviewed 120 anesthesiologists (physicians and nurses) about the topic: "Common problems with patient monitoring in your daily work." Through deductive and inductive coding, we identified themes and subthemes from the interviews. Secondly, we conducted a field survey with a separate group of 25 anesthesiologists who rated their agree- or disagreement with central statements based on the themes identified from the interviews. RESULTS We identified the following six main topics: 1. "Alarms," 2. "Artifacts," 3. "Software," 4. "Hardware," 5. "Human Factors," 6. "System Factors," and 17 sub-topics. The central statements based on each major theme were: 1. “problems with alarm settings complicate the work with patient monitoring.” (96% agreed) 2. “artifacts complicate the assessment of the patient's condition.” (56% agreed) 3. “information overload makes it difficult to get a quick overview of the situation.” (56% agreed) 4. “problems with cables make working with patient monitors tedious.” (88% agreed) 5. “factors related to human performance lead to patient conditions not being perceived on the monitor.” (64% agreed) 6. “Insufficient standardization: Switching back and forth between monitors from different manufacturers makes it difficult to work with patient monitors.” (88% agreed). All statements differed significantly from the neutral opinion. CONCLUSION This study provides an overview of the problems anesthesiologists face with patient monitoring. Some of the issues identified were previously less known, such as problems with monitor cables (e.g., entanglement and worn connectors), human factors (e.g., fatigue and distractions), and systemic factors (e.g., insufficient standardization between manufacturers). According to our findings, an ideal monitor should reduce false positive alarms to a minimum, use as few cables as possible, and be easy to interpret.

scholarly journals It’s not you, it’s the design - common problems with patient monitoring reported by anesthesiologists: a mixed qualitative and quantitative study.

2019 ◽  
Author(s):  
David Tscholl ◽  
Lucas Handschin ◽  
Julian Rössler ◽  
Mona Weiss ◽  
Donat R. Spahn ◽  
...  
Keyword(s):  
Quantitative Study ◽  
Patient Monitoring ◽  
Human Performance ◽  
Information Overload ◽  
Alarm Fatigue ◽  
Daily Work ◽  
Therapeutic Decisions ◽  
Systemic Factor ◽  
Common Problems ◽  
Qualitative And Quantitative Study

Abstract BACKGROUND Patient monitoring is critical for perioperative patient safety as anesthesiologists routinely make crucial therapeutic decisions from the information displayed on patient monitors. Previous research has shown that today's patient monitoring has room for improvement in areas such as information overload and alarm fatigue. The rationale of this study was to learn more about the problems anesthesiologists face in patient monitoring and to derive improvement suggestions for next-generation patient monitors. METHODS We conducted a two-center qualitative/quantitative study. Initially, we interviewed 120 anesthesiologists (physicians and nurses) about the topic: common problems with patient monitoring in your daily work. Through deductive and inductive coding, we identified major topics and sub themes from the interviews. In a second step, a field survey, a separate group of 25 anesthesiologists rated their agree- or disagreement with central statements created for all identified major topics. RESULTS We identified the following six main topics: 1. "Alarms," 2. "Artifacts," 3. "Software," 4. "Hardware," 5. "Human Factors," 6. "System Factors," and 17 sub themes. The central statements rated for the major topics were: 1. “problems with alarm settings complicate patient monitoring.” (96% agreed) 2. “artifacts complicate the assessment of the situation.” (56% agreed) 3. “information overload makes it difficult to get an overview quickly.” (56% agreed) 4. “problems with cables complicate working with patient monitors.” (88% agreed) 5. “factors related to human performance lead to critical information not being perceived.” (64% agreed) 6. “Switching between monitors from different manufacturers is difficult.” (88% agreed). The ratings of all statements differed significantly from neutral opinion (all p<0.03). CONCLUSION This study provides an overview of the problems anesthesiologists face in patient monitoring. Some of the issues, to our knowledge, were not previously identified as common problems in patient monitoring, e.g., hardware problems (e.g., cable entanglement and worn connectors), human factor aspects (e.g., fatigue and distractions), and systemic factor aspects (e.g., insufficient standardization between manufacturers). An ideal monitor should transfer the relevant patient monitoring information as efficiently as possible, prevent false positive alarms, and use technologies designed to improve the problems in patient monitoring.

scholarly journals User perceptions of avatar-based patient monitoring: a mixed qualitative and quantitative study

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
David W. Tscholl ◽  
Mona Weiss ◽  
Lucas Handschin ◽  
Donat R. Spahn ◽  
Christoph B. Nöthiger
Keyword(s):  
Quantitative Study ◽  
Patient Monitoring ◽  
User Perceptions ◽  
Qualitative And Quantitative ◽  
Qualitative And Quantitative Study

Qualitative and Quantitative Study of Verbal Behavior Style in Interviews with Patient's Companion in Family Medicine: Understanding and Measuring

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Turabian Jose Luis ◽  
Minier-Rodriguez Luis Enoc ◽  
Moreno-Ruiz Sandra ◽  
Rodriguez-Almonte Francis Eliant ◽  
Cucho-Jove Raul ◽  
...  
Keyword(s):  
Family Medicine ◽  
Verbal Behavior ◽  
Quantitative Study ◽  
Qualitative And Quantitative ◽  
Qualitative And Quantitative Study

A Qualitative and Quantitative Study of the Innervation of the Human Non Pregnant Uterus

2016 ◽  
Vol 18 (2) ◽  
pp. 140-148 ◽  
Author(s):  
Silvia Tommaso ◽  
Carlo Cavallotti ◽  
Antonio Malvasi ◽  
Daniele Vergara ◽  
Antonio Rizzello ◽  
...  
Keyword(s):  
Quantitative Study ◽  
Pregnant Uterus ◽  
Qualitative And Quantitative ◽  
Qualitative And Quantitative Study

Mating in the harvestman Leiobunum vittatum (Arachnida: Opiliones): from premating struggles to solicitous tactile engagement

Behaviour ◽  
2014 ◽  
Vol 151 (12-13) ◽  
pp. 1663-1686 ◽  
Author(s):  
Kasey D. Fowler-Finn ◽  
Emilia Triana ◽  
Owen G. Miller
Keyword(s):  
Morphological Traits ◽  
Nuptial Gift ◽  
Multiple Sources ◽  
Male Size ◽  
Mechanical Advantage ◽  
Qualitative And Quantitative ◽  
Mutual Mate Choice ◽  
Males And Females ◽  
Qualitative And Quantitative Study ◽  
Multiple Stages

When mating interactions are influenced by multiple sources of selection, they may involve multiple stages of mate assessment. At each stage, a different set of morphological and behavioural traits may be important in determining the outcome of the interaction. Here, we test the potential for multiple sources of selection to shape mating interactions in Leiobunum vittatum harvestmen, commonly known as ‘daddy longlegs’. We provide a qualitative and quantitative study of mating interactions, and investigate the influence of multiple morphological traits on each of several distinct stages of their mating interactions. Mating interactions start with a struggle between males and females during which the male attempts to secure the females in a mating embrace. Success at this stage depends on the length of the male’s clasping pedipalps: those with shorter pedipalps (and thus greater mechanical advantage) were more successful. Male size relative to the female determines how quickly males achieve this embrace. Mating interactions then proceed to tactile exchanges between males and females, indicating the potential for mutual mate choice and/or peri- and post-copulatory selection. We found no morphological predictors of the timing of these later stages of the mating interactions, and suggest that the exchange of a nuptial gift is important for the dynamics of these stages. Overall, our results highlight L. vittatum as a potentially highly informative group for studying how traits involved in mating are shaped by the interaction of selection across multiple stages in mating interactions.

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