scholarly journals Patient Monitoring Alarms of an Intensive Care Unit: Observational Study with DIY Instructions (Preprint)

2020 ◽  
Author(s):  
Akira-Sebastian Poncette ◽  
Maximilian Markus Wunderlich ◽  
Claudia Spies ◽  
Patrick Heeren ◽  
Gerald Vorderwülbecke ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Observational Study ◽  
Response Time ◽  
Monitoring System ◽  
Patient Monitoring ◽  
Monitoring Data ◽  
Patient Monitoring System

BACKGROUND As one of the most essential technical components of the intensive care unit (ICU), continuous monitoring of patients’ vital parameters has significantly improved patient safety by alerting staff through an alarm when a parameter deviates from the normal range. However, the vast amount of alarms regularly overwhelms staff, and induces alarm fatigue that endangers patients. OBJECTIVE This study focused on providing a complete and repeatable analysis of the alarm data of an ICU’s patient monitoring system. We aimed to develop do-it-yourself (DIY) instructions for technically versed ICU staff to analyse their monitoring data themselves, which is an essential element for developing efficient and effective alarm optimization strategies. METHODS This observational study was conducted using alarm log data extracted from the patient monitoring system of a 21-bed surgical ICU in 2019. DIY instructions were iteratively developed in informal interdisciplinary team meetings. The data analysis was grounded on a framework consisting of five dimensions, each with specific metrics: alarm load, ie, alarms per bed per day, alarm flood conditions, alarm per device and per criticality; avoidable alarms, ie, the amount of technical alarms; responsiveness and alarm handling, ie response time; sensing, ie, usage of the alarm pause function; and exposure, ie, alarms per room type. Results were visualized using the R package ggplot2 to provide detailed temporal insights into the ICU’s alarm situation. RESULTS We developed step by step DIY instructions for self-analysis of patient monitoring data, including the scripts for data preparation and analysis. The alarm load in the respective ICU was quantified by 152.5 alarms per bed per day on average (SD 42.2), and alarm flood conditions with on average 69.55 per day (SD 31.12) that both occurred mostly in the morning shifts. Most alarms were issued by the ventilator, invasive blood pressure device and electrocardiogram (ie, high and low blood pressure, high respiratory rate, low heart rate). In regard to avoidable alarms, technical alarms by the ECG were the most frequent (eg, lead fallen off). The median response time to alarms yielded 8s (range 0-600). The alarm pause function was applied 10.86 times per bed per day (SD 2.6), and in 91% (19,334/21,194) was not actively terminated, resulting in a proper pause to pause ratio of 0.09:1. The exposure to alarms per bed per day was higher in single rooms (26%, mean 172.9/137.2 alarms per day per bed). 69% of all alarms (2,199.9/3,202.4, SD 651.2) were on average issued by 7.6 of 21 beds per day (36%). CONCLUSIONS Analyzing ICU alarm log data provides valuable insights into the current alarm situation. Our results call for alarm management interventions that effectively reduce the number of alarms in order to ensure patient safety and ICU staff’s work satisfaction. We hope our DIY instructions encourage others to follow suit in analyzing and publishing their ICU alarm data. CLINICALTRIAL NCT04661735

scholarly journals An Intelligent Intensive Care Unit for Patient Monitoring System

NCICCNDA ◽  
2018 ◽  
Author(s):  
Manasa I R ◽  
Pallavi M ◽  
Priyanka S G ◽  
Suma B ◽  
Madhu M Nayak
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Monitoring System ◽  
Patient Monitoring ◽  
Patient Monitoring System

scholarly journals Computerised Patient Monitoring in Intensive Care

1982 ◽  
Vol 10 (3) ◽  
pp. 229-232 ◽  
Author(s):  
T. E. Oh ◽  
J. L. Black ◽  
J. N. de Roach ◽  
N. J. Davis
Keyword(s):  
Intensive Care ◽  
Monitoring System ◽  
Patient Monitoring ◽  
Data Entry ◽  
Patient Monitoring System ◽  
Cardiovascular Variables

A specially designed computerised patient-monitoring system surveys electroencephalogram and cardiovascular variables continuously, as well as up to twelve other variables at timed intervals. Special features include trend recordings, alarms, marking facilities and “suspend” monitoring. The ease of data entry and recall is an advantage.

scholarly journals Checklist for the intrahospital transport of patients admitted to the Intensive Care Unit

2015 ◽  
Vol 24 (2) ◽  
pp. 539-547 ◽  
Author(s):  
Renata da Silva ◽  
Lúcia Nazareth Amante
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Adverse Events ◽  
Patient Evaluation ◽  
Intrahospital Transport ◽  
Integrative Research ◽  
Simple Tool ◽  
Peripheral Arterial

Checklists represent a simple tool incorporating barriers for protecting patient safety. The objective was to develop a script for patient evaluation for the intrahospital transport of patients admitted to the Intensive Care Unit of a hospital in the Triângulo Mineiro region, based on two strategies. The first: a descriptive, prospective and quantitative study; the second: integrative research, undertaken in four databases. It was ascertained that the incidents are related to breakdowns and problems related to poor functioning in equipment and devices, with adverse events being frequent involving variation in blood pressure, agitation, drops in peripheral arterial saturation and tachycardia. Emphasis is also placed on the need to verify the effectiveness of the present script for patient evaluation for intrahospital transport in relation to patient safety, and its level of practicality through its use in the varying hospital spaces, such that the same may become a checklist.

scholarly journals Patient Monitoring Alarms of an Intensive Care Unit: Observational Study with DIY Instructions (Preprint)

10.2196/26494 ◽  
2020 ◽  
Author(s):  
Akira-Sebastian Poncette ◽  
Maximilian Markus Wunderlich ◽  
Claudia Spies ◽  
Patrick Heeren ◽  
Gerald Vorderwülbecke ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Patient Monitoring

scholarly journals Clinical Requirements of Future Patient Monitoring in the Intensive Care Unit: Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Akira-Sebastian Poncette ◽  
Claudia Spies ◽  
Lina Mosch ◽  
Monique Schieler ◽  
Steffen Weber-Carstens ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Qualitative Study ◽  
Patient Monitoring ◽  
Digital Health ◽  
Alarm Management ◽  
Novel Technology ◽  
Future Patient

BACKGROUND In the intensive care unit (ICU), continuous patient monitoring is essential to detect critical changes in patients’ health statuses and to guide therapy. The implementation of digital health technologies for patient monitoring may further improve patient safety. However, most monitoring devices today are still based on technologies from the 1970s. OBJECTIVE The aim of this study was to evaluate statements by ICU staff on the current patient monitoring systems and their expectations for future technological developments in order to investigate clinical requirements and barriers to the implementation of future patient monitoring. METHODS This prospective study was conducted at three intensive care units of a German university hospital. Guideline-based interviews with ICU staff—5 physicians, 6 nurses, and 4 respiratory therapists—were recorded, transcribed, and analyzed using the grounded theory approach. RESULTS Evaluating the current monitoring system, ICU staff put high emphasis on usability factors such as intuitiveness and visualization. Trend analysis was rarely used; inadequate alarm management as well as the entanglement of monitoring cables were rated as potential patient safety issues. For a future system, the importance of high usability was again emphasized; wireless, noninvasive, and interoperable monitoring sensors were desired; mobile phones for remote patient monitoring and alarm management optimization were needed; and clinical decision support systems based on artificial intelligence were considered useful. Among perceived barriers to implementation of novel technology were lack of trust, fear of losing clinical skills, fear of increasing workload, and lack of awareness of available digital technologies. CONCLUSIONS This qualitative study on patient monitoring involves core statements from ICU staff. To promote a rapid and sustainable implementation of digital health solutions in the ICU, all health care stakeholders must focus more on user-derived findings. Results on alarm management or mobile devices may be used to prepare ICU staff to use novel technology, to reduce alarm fatigue, to improve medical device usability, and to advance interoperability standards in intensive care medicine. For digital transformation in health care, increasing the trust and awareness of ICU staff in digital health technology may be an essential prerequisite. CLINICALTRIAL ClinicalTrials.gov NCT03514173; https://clinicaltrials.gov/ct2/show/NCT03514173 (Archived by WebCite at http://www.webcitation.org/77T1HwOzk)

scholarly journals The Patient’s Situation During Interhospital Intensive Care Unit-to-Unit Transfers: A Hermeneutical Observational Study

2019 ◽  
Vol 29 (12) ◽  
pp. 1687-1698 ◽  
Author(s):  
Jonas Karlsson ◽  
Thomas Eriksson ◽  
Berit Lindahl ◽  
Isabell Fridh
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Observational Study ◽  
Complex Task ◽  
Video Recordings ◽  
Vulnerable Patients ◽  
Field Notes ◽  
Using Data ◽  
Video Material

Interhospital intensive care unit-to-unit transfers are an increasing phenomenon, earlier mainly studied from a patient safety perspective. Using data from video recordings and participant observations, the aim was to explore and interpret the observed nature of the patient’s situation during interhospital intensive care unit-to-unit transfers. Data collection from eight transfers resulted in over 7 hours of video material and field notes. Using a hermeneutical approach, three themes emerged: being visible and invisible; being in a constantly changing space; and being a fettered body in constant motion. The patient’s situation can be viewed as an involuntary journey, one where the patient exists in a constantly changing space drifting in and out of the health personnel’s attention and where movements from the journey become part of the patient’s body. Interhospital transfers of vulnerable patients emerge as a complex task, challenging the health personnel’s ability to maintain a caring atmosphere around these patients.

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