Bedside Communication and Management of Vital Parameters and Alarms in Care-Intensive Environments: Simulation Model Development for the Clinical Effectiveness Analysis of An Innovative Technology
Main Article Content
Keywords
Alarm fatigue, Safety, Communication, Clinical effectiveness, Simulation model, Workflow, Vitalsigns
Abstract
Background and Objective: The deliberation n.7301 of 31/12/2001 provides for the inclusion of a call system with acoustic and luminous signaling within the minimum equipment of the recovery ward. However, traditional call systems are inefficient since they are based on the following incorrect assumptions: patients and staff are unmoving, information sources are static, and assistance is unidirectional. Taking care of a patient involves different personnel who should be dynamic and should be able to exchange information. Furthermore, the high number of clinical calls and alarms might be an issue, as they are essential to fulfill patients’ needs, but could cause stress and additional workload for medical staff. Indeed, they sometimes ignore some calls or waste time on non-urgent requests. Also, the identification of an alarm and prompt intervention seems to be more difficult during travel. An ideal alarm system should have 100% sensitivity and specificity. However, the alarms are designed to be extremely sensitive, at the expense of specificity. The alarm fatigue, that is the work overload due to an excessive alarms number exposition, is a critical problem in terms of safety in the current clinical practice because it involves desensitization and alarm loss, and occasionally a patient's death.
Material and Methods: Appropriate approaches to notifications should be evaluated, including the effectiveness of mobile wireless technologies that are key to linking patients, staff, data, services, and medical devices which simplifies communications and workflows. Several issues related to the communication among staff members, between patient and caregiver, and regarding the alarms and vital parameters distribution in care-intensive environments have been analyzed. The focus was on the clinical effectiveness analysis of innovative technology to support the activities in the Emergency Department of the Azienda Ospedaliera dei Colli. Afterward, we created a simulation model with Simul8, so that a digital twin reproduces direct and indirect activities in two cases: with and without (What If and As Is model) the aid of the technology.
Results and Conclusions: The model provides a set of Key Performance Indicators (number of performing activities, average alarm resolution time, wait time) on which the compensatory aggregation method is applied to obtain a single final score in both cases. This score is 52.5 in the As Is Model and 80 in the What If model. So, clinical effectiveness has been demonstrated
Downloads
Abstract 959 | PDF Downloads 767
References
2.Hendrich A, Chow MP, Skierczynski BA, et al. A 36-Hospital Time And Motion Study: How Do Medical-Surgical Nurses Spend Their Time? Permanente J 2008;12(3):25–34.
3.Pepino A, Torri A, Tamburis O. Implementing simulation-based approaches for healthcare workflow analysis: the case of a department of laboratory medicine in South Italy. Proc. of the Third Intl. Conf. Advances in Computing, Communication and Information Technology- CCIT 2015; Institute of Research Engineers and Doctors, USA. ISBN: 978-1-63248-061-3 doi: 10.15224/ 978-1-63248-061-3-11.
4.Sendelbach S, Funk M. Alarm fatigue: A patient safety concern. AACN Adv Crit Care 2013;24(4):378–86.
5.Ventola CL. Mobile Devices and Apps for Health Care Professionals: Uses and Benefits. P T 2014;39(5):356–64.
6.Ascom Holding AG. Website. Available at: www.ascom.com.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
Author(s) must obtain all parties consent [co-author(s), others if applicable] and submit the acceptance of Copyright Agreement with their paper. Written permission must be obtained by the author for material that has been published in copyrighted material; this includes tables, figures, and quoted text that exceeds 150 words. A copy of all permissions must accompany the manuscript when published in copyrighted material. The author(s) hereby represents and warrants that the paper is original and that he/she is the author of the paper, except for material that is clearly identified as to its original source, with permission notices from the copyright owners where required. Author(s) must clearly indicate that approval for publication has been received in cases of institutional ownership.
In all submitted material authors retain all copyrights; however, the GlobalCE Journal reserve the right to reprint all or portions of the article and to post all or part of the article online. GlobalCE Journal reserves the right to edit manuscripts as required to publish in the journal. Authors are responsible for obtaining any and all clearances as appropriate. Unless stated otherwise, all articles are open-access and distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original author(s) and original work (e.g. first published in the Global Clinical Engineering Journal) is properly cited with the original URL and bibliographic citation information. The complete bibliographic information, a link to the original publication on www.Globalce.org well as the copyright and license information must be included. No use, distribution or reproduction is permitted which does not comply with these terms.
