Flohr Luisa, Beaudry Shaylene, Johnson K Taneille, West Nicholas, Burns Catherine M, Ansermino J Mark, Dumont Guy A, Wensley David, Skippen Peter, Gorges Matthias
Faculty of MedicineThe University of British ColumbaVancouverBCV6T 1Z3Canada.
Department of AnesthesiologyPharmacology and TherapeuticsThe University of British ColumbaVancouverBCV6T 1Z3Canada.
IEEE J Transl Eng Health Med. 2018 Mar 5;6:3000114. doi: 10.1109/JTEHM.2018.2812162. eCollection 2018.
The pediatric intensive care unit (ICU) is a complex environment, in which a multidisciplinary team of clinicians (registered nurses, respiratory therapists, and physicians) continually observe and evaluate patient information. Data are provided by multiple, and often physically separated sources, cognitive workload is high, and team communication can be challenging. Our aim is to combine information from multiple monitoring and therapeutic devices in a mobile application, the , to improve the efficiency of clinical decision-making, communication, and thereby patient safety. We observed individual ICU clinicians, multidisciplinary rounds, and handover procedures for 54 h to identify data needs, workflow, and existing cognitive aid use and limitations. A prototype was developed using an iterative participatory design approach; usability testing, including general and task-specific feedback, was obtained from 15 clinicians. Features included map overviews of the ICU showing clinician assignment, patient status, and respiratory support; patient vital signs; a photo-documentation option for arterial blood gas results; and team communication and reminder functions. Clinicians reported the prototype to be an intuitive display of vital parameters and relevant alerts and reminders, as well as a user-friendly communication tool. Future work includes implementation of a prototype, which will be evaluated under simulation and real-world conditions, with the aim of providing ICU staff with a monitoring device that will improve their daily work, communication, and decision-making capacity. Mobile monitoring of vital signs and therapy parameters might help improve patient safety in wards with single-patient rooms and likely has applications in many acute and critical care settings.
儿科重症监护病房（ICU）是一个复杂的环境，临床医生（注册护士、呼吸治疗师和医生）的多学科团队在此持续观察和评估患者信息。数据由多个且通常在物理上分离的来源提供，认知工作量很大，团队沟通也具有挑战性。我们的目标是在一个移动应用程序中整合来自多个监测和治疗设备的信息，即[应用程序名称未给出]，以提高临床决策、沟通的效率，从而提高患者安全性。我们对ICU临床医生进行了54小时的个体观察、多学科查房及交接班程序观察，以确定数据需求、工作流程以及现有认知辅助工具的使用情况和局限性。采用迭代式参与设计方法开发了一个原型；从15名临床医生那里获得了可用性测试反馈，包括一般反馈和特定任务反馈。其功能包括ICU的地图概述，显示临床医生分配情况、患者状态和呼吸支持；患者生命体征；动脉血气结果的照片记录选项；以及团队沟通和提醒功能。临床医生报告称，该原型能直观显示重要参数及相关警报和提醒，也是一个用户友好的沟通工具。未来的工作包括实施该原型，将在模拟和实际条件下对其进行评估，目的是为ICU工作人员提供一种监测设备，以改善他们的日常工作、沟通和决策能力。对生命体征和治疗参数的移动监测可能有助于提高单人病房的患者安全性，并且可能在许多急性和重症监护环境中具有应用价值。
