Document Detail


A Far-View Intensive Care Unit Monitoring Display Enables Faster Triage.
MedLine Citation:
PMID:  21654229     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Although nurses perform the majority of the clinical tasks in an intensive care unit, current patient monitors were not designed to support a nurse's workflow. Nurses constantly triage patients, deciding which patient is currently in the most need of care. To make this decision, nurses must observe the patient's vital signs and therapeutic device information from multiple sources. To obtain this information, they often have to enter the patient's room. This study addresses 3 hypotheses. Information provided by far-view monitoring displays (1) reduces the amount of time to determine which patient needs care first, (2) increases the accuracy of assigning priority to the right patient, and (3) reduces nurses mental workload. We developed 2 far-view displays to be read from a distance of 3 to 5 m without entering the patient's room. Both display vital signs, trends, alarms, infusion pump status, and therapy support indicators. To evaluate the displays, nurses were asked to use the displays to decide which of 2 patients required their attention first. They made 60 decisions: 20 with each far-view display and 20 decisions with a standard patient monitor next to an infusion pump. Sixteen nurses (median age of 27.5 years with 2.75 years of experience) participated in the study. Using the 2 far-view displays, nurses more accurately and rapidly identified stable patients and syringe pumps that were nearly empty. Median decision times were 11.3 and 12.4 seconds for the 2 far-view displays and 17.2 seconds for the control display. The 2 far-view displays reduced median decision-making times by 4.8 to 5.9 seconds, increased accuracy in assignment of priority in 2 of 7 patient conditions, and reduced nurses' frustration with the triaging task. In a clinical setting, the proposed far-view display might reduce nurses' mental workload and thereby increase patient safety.
Authors:
Matthias Görges; Kai Kück; Sven H Koch; Jim Agutter; Dwayne R Westenskow
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Dimensions of critical care nursing : DCCN     Volume:  30     ISSN:  1538-8646     ISO Abbreviation:  -     Publication Date:    2011 July/August
Date Detail:
Created Date:  2011-6-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211489     Medline TA:  Dimens Crit Care Nurs     Country:  -    
Other Details:
Languages:  ENG     Pagination:  206-217     Citation Subset:  -    
Affiliation:
Matthias Görges, PhD, is from the Department of Anesthesiology, University of Utah, Salt Lake City. Dr Görges received his MSc in Biomedical Engineering from HAW-Hamburg, Germany, and a PhD in Bioengineering from the University of Utah, Salt Lake City. He is currently a postdoctoral fellow in the Electrical and Computer Engineering Department at the University of British Columbia, Vancouver, Canada. Dr Görges' research interests include the improvement of patient monitoring alarms, the development of integrated medical displays, and proving decision support tools to nurses in the intensive care unit. Kai Kück, PhD, is from the Research Division, Drägerwerk AG & Co KGaA, Lübeck, Germany. Dr Kück received his Dipl-Ing. (FH) in Biomedical Engineering from HAW-Hamburg, Germany, and a PhD in Bioengineering from the University of Utah, Salt Lake City. Currently, he is the head of research of Drägerwerk AG & Co KGaA, Lübeck, Germany. Dr Kück's research interests are intensive care and perioperative monitoring and mechanical ventilation. Sven H. Koch, PhD, is from the Department of Anesthesiology, University of Utah, Salt Lake City. Dr Koch received his Dipl Med-Inf. from the University of Heidelberg, Germany, and a PhD in Biomedical Informatics from the University of Utah, Salt Lake City. He is currently with the Institute of Medical Biometry and Informatics, Heidelberg University, Germany. His research interests are in usability and human factors in health care, especially in developing information displays for nurses and physicians. Jim Agutter, MArch, is from the College of Architecture+Planning, University of Utah, Salt Lake City. Mr Agutter received his MArch from the University of Utah, Salt Lake City. Currently, he is an assistant research professor and director of design program at the College of Architecture and Planning at the University of Utah. His research interests are the application of 2-dimensional and 3-dimensional design concepts to large-scale, real-time data environments. Dwayne R. Westenskow, PhD, is from the Department of Anesthesiology, University of Utah, Salt Lake City. Dr Westenskow received an MSc and PhD in Bioengineering from the University of Utah, Salt Lake City. He is currently a professor and holder of the Harry C. Wong, MD, Presidential Chair in Anesthesiology at the University of Utah and serves as director of the Anesthesiology Bioengineering Laboratory. Dwayne's research interests are to develop and apply technology in the design of medical devices for the operating room and intensive care unit. Specific areas of interest are data visualization, neural networks, feedback control, and digital signal processing.
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