Improving Fluid Output Monitoring in the Intensive Care Unit

Purpose: To assess the potential clinical impact of an automated urine output (UOP) monitoring system in the intensive care unit. Methods: Frequency of UOP documentation during a 20-month period was assessed in records of inpatients on the medicine floor, cardiac intensive care (CCU), and cardiothoracic-intensive care units (CTICU). Documentation timeliness (time between expected and observed UOP recording) was assessed over a 3-month period. A novel reusable device that monitors UOP based on continuous analysis of the weight of a urine collection container was tested in the CCU/CTICU. Results: A total of 165,363 UOP measurements were recorded for 2,039 CCU/CTICU admissions. Sixty percent of CCU/CTICU admissions had UOP recorded in the electronic medical record (EMR) less than every 2 hours. One-third of CCU/CTICU measurements were documented more than 2 hours late, and only 10% were recorded less than 20 minutes late. Half of these patients had fewer than 2 measurements recorded per nursing shift and recordings were documented an average of 85 minutes late. There was no significant difference between daytime and nighttime shifts. UOP values obtained by the novel electronic monitoring device were within 27 ml (−224 ml, +228 ml) of nurses documented values, across 74 patients over a 24-hour period. Conclusions: Automating UOP monitoring using a reusable weight-based device is feasible and can improve timeliness of documentation and reduce nursing workload without compromising accuracy.

Didactic Opportunities of Information-Communication Technologies in the Control of Physical Education

The study objective is to justify and implement information and communication technologies in the test control of the development level of the frequency of movements, as a manifestation of speed qualities in the process of physical education. Materials and Methods. To solve the research tasks, the study used the methods of comparing and contrasting, analysis, synthesis, abstraction, formalization and technical modeling. Results. An electronic device for the exercise controlling the movement frequency of the hands to evaluate speed qualities was developed for the research purpose. The device is designed on the basis of capacitive type proximity sensors. The signal received by the sensors is processed in the microcontroller unit during the test and transmitted to the personal computer via the communication interface. On a personal computer, using the developed software, they control the time of completion of the test task. Conclusions. The developed information and communication technologies based on electronic monitoring device embodies a new approach to addressing the challenge of improving the performance of speed control in physical education by ensuring that objective and reliable test data are obtained promptly.

Adolescent and caregivers’ experiences of electronic adherence assessment in paediatric problematic severe asthma

This study explored the experiences of adolescents and their caregivers regarding adherence to inhaled corticosteroids which are assessed through an electronic monitoring device (EMD). These devices are increasingly being used for assessing medication adherence, yet there is little information about patient’s experience of these tools. Semi-structured interviews were conducted with eight adolescents with severe asthma, aged 11–15 years, who were electronically monitored as part of their care, along with their caregivers. Interviews were analysed using thematic analysis. Three themes were identified: ‘they were trying to help me get better’, ‘checking up and catching out’ and ‘who is responsible?’ The themes highlighted differences in priorities between participant groups, the impact of monitoring on the healthcare relationship and the dilemma of transferring responsibility for asthma management to adolescents. The findings suggest it is important for healthcare professionals to engage with patient’s preferences and priorities when introducing EMDs.