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 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 The feasibility and reliability of actigraphy to monitor sleep in intensive care patients: an observational study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
L. J. Delaney ◽  
E. Litton ◽  
K. L. Melehan ◽  
H.-C. C. Huang ◽  
V. Lopez ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Moderate Level ◽  
Sleep Monitoring ◽  
Clinical Trial Registration ◽  
Wake Time ◽  
Intensive Care Patients

Abstract Background Sleep amongst intensive care patients is reduced and highly fragmented which may adversely impact on recovery. The current challenge for Intensive Care clinicians is identifying feasible and accurate assessments of sleep that can be widely implemented. The objective of this study was to investigate the feasibility and reliability of a minimally invasive sleep monitoring technique compared to the gold standard, polysomnography, for sleep monitoring. Methods Prospective observational study employing a within subject design in adult patients admitted to an Intensive Care Unit. Sleep monitoring was undertaken amongst minimally sedated patients via concurrent polysomnography and actigraphy monitoring over a 24-h duration to assess agreement between the two methods; total sleep time and wake time. Results We recruited 80 patients who were mechanically ventilated (24%) and non-ventilated (76%) within the intensive care unit. Sleep was found to be highly fragmented, composed of numerous sleep bouts and characterized by abnormal sleep architecture. Actigraphy was found to have a moderate level of overall agreement in identifying sleep and wake states with polysomnography (69.4%; K = 0.386, p < 0.05) in an epoch by epoch analysis, with a moderate level of sensitivity (65.5%) and specificity (76.1%). Monitoring accuracy via actigraphy was improved amongst non-ventilated patients (specificity 83.7%; sensitivity 56.7%). Actigraphy was found to have a moderate correlation with polysomnography reported total sleep time (r = 0.359, p < 0.05) and wakefulness (r = 0.371, p < 0.05). Bland–Altman plots indicated that sleep was underestimated by actigraphy, with wakeful states overestimated. Conclusions Actigraphy was easy and safe to use, provided moderate level of agreement with polysomnography in distinguishing between sleep and wakeful states, and may be a reasonable alternative to measure sleep in intensive care patients. Clinical Trial Registration number ACTRN12615000945527 (Registered 9/9/2015).

scholarly journals Insights into the Problem of Alarm Fatigue with Physiologic Monitor Devices: A Comprehensive Observational Study of Consecutive Intensive Care Unit Patients

PLoS ONE ◽  
2014 ◽  
Vol 9 (10) ◽  
pp. e110274 ◽  
Author(s):  
Barbara J. Drew ◽  
Patricia Harris ◽  
Jessica K. Zègre-Hemsey ◽  
Tina Mammone ◽  
Daniel Schindler ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Alarm Fatigue

scholarly journals Contamination of Propofol Infusions in the Intensive Care Unit: Incidence and Clinical Significance

1998 ◽  
Vol 26 (2) ◽  
pp. 162-164 ◽  
Author(s):  
S. A. R. Webb ◽  
B. Roberts ◽  
F. X. Breheny ◽  
C. L. Golledge ◽  
P. D. Cameron ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Nosocomial Infection ◽  
Wound Infection ◽  
Clinical Significance ◽  
Low Grade ◽  
Clinical Infection ◽  
Icu Patients

Epidemics of bacteraemia and wound infection have been associated with the infusion of bacterially contaminated propofol administered during anaesthesia. We conducted an observational study to determine the incidence and clinical significance of administration of potentially contaminated propofol to patients in an ICU setting. One hundred patients received a total of 302 infusions of propofol. Eighteen episodes of possible contamination of propofol syringes were identified, but in all cases contamination was by a low-grade virulence pathogen. There were no episodes of clinical infection or colonization which could be attributed to the administration of contaminated propofol. During the routine use of propofol to provide sedation in ICU patients the risk of nosocomial infection secondary to contamination of propofol is extremely low.

Invasive fungal infections in the intensive care unit: a multicentre, prospective, observational study in Italy (2006-2008)

Mycoses ◽  
2011 ◽  
Vol 55 (1) ◽  
pp. 73-79 ◽  
Author(s):  
Anna Maria Tortorano ◽  
Giovanna Dho ◽  
Anna Prigitano ◽  
Giuseppe Breda ◽  
Anna Grancini ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Fungal Infections ◽  
Invasive Fungal Infections
Sign in / Sign up

Export Citation Format

Share Document