| Near real-time notification of gaps in cuff blood pressure recordings for improved patient monitoring. | |
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MedLine Citation:
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PMID: 23283561 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Blood pressure monitoring during anesthesia is an American Society of Anesthesiology standard. However, the anesthesia provider sometimes fails to engage the patient monitor to make periodic (generally every 3-5 min) measurements of Non-Invasive Blood Pressure (NIBP), which can lead to extended periods (>5 min) when blood pressure is not monitored. We describe a system to automatically detect such gaps in NIBP measurement and notify clinicians in real-time to initiate measurement. We applied a decision support system called the Smart Anesthesia Messenger (SAM) to notify the anesthesia provider if NIBP measurements have not been made in the last 7 min. Notification messages were generated only if direct arterial blood pressure was not being monitored. NIBP gaps were analyzed for 9 months before and after SAM notification was initiated (12,000 cases for each period). SAM notification was able to reduce the occurrence of extended NIBP gaps >15 min from 15.7 ± 4.5 to 6.7 ± 2.0 instances per 1,000 cases (p < 0.001). In addition, for extended gaps (>15 min) the mean gap duration declined from 23.1 ± 2.0 to 18.6 ± 1.1 min after SAM notification was initiated (p < 0.001). However, for 7-15 min gaps, SAM notification was not effective in reducing the occurrence. The maximum gap encountered before SAM was 64 min, while it was 27 min with SAM notification. Real-time notification using SAM is an effective way to reduce both the number of instances and the duration of inadvertent, extended (>15 min) gaps in blood pressure measurements in the operating room. However, the frequency of gaps <15 min could not be reduced using the current configuration of SAM. |
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Authors:
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Bala G Nair; Mayumi Horibe; Shu-Fang Newman; Wei-Ying Wu; Howard A Schwid |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-3 |
Journal Detail:
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Title: Journal of clinical monitoring and computing Volume: - ISSN: 1573-2614 ISO Abbreviation: J Clin Monit Comput Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-3 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9806357 Medline TA: J Clin Monit Comput Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Anesthesiology and Pain Medicine, University of Washington, BB-1469 Health Sciences Bldg, 1959 NE Pacific Street, Mail Box: 356540, Seattle, WA, 98195, USA, nairbg@uw.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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