Medical Devices: Evidence and Research (Aug 2022)
Use of a Portable Electronic Interface Improves Clinical Handoffs and Adherence to Lung Protective Ventilation
Abstract
Neil R Euliano,1 Paul Stephan,1 Konstantinos Michalopoulos,1 Michael A Gentile,2 A Joseph Layon,3 Andrea Gabrielli4 1Convergent Engineering, Inc, Gainesville, FL, USA; 2Department of Anesthesiology, Duke University, Durham, NC, USA; 3Department of Anesthesiology, College of Medicine, University of Central Florida, Orlando, FL, USA; 4Miller School of Medicine, University of Miami, Miami, FL, USACorrespondence: Neil R Euliano, Convergent Engineering, Inc, 100 SW 75th Street, STE 106, Gainesville, FL, 32607, USA, Tel +1 352 378 4899 x 107, Fax +1 352 378 9202, Email [email protected]: Mechanical ventilation (MV) is used to support patients with respiratory impairment. Evidence supports the use of lung-protective ventilation (LPV) during MV to improve outcomes. However, studies have demonstrated poor adherence to LPV guidelines. We hypothesized that an electronic platform adapted to a hand-held tablet receiving real-time ventilatory parameters could increase clinician awareness of key LPV parameters. Furthermore, we speculated that an electronic shift-change tool could improve the quality of clinician handoffs.Methods: Using a specially designed Wi-Fi dongle to transmit data from three ventilators and a respiratory monitor, we implemented a system that displays data from all ventilators under the care of a Respiratory Care Practitioner (RCP) on an electronic tablet. In addition, the tablet created a handoff checklist to improve shift-change communication. In a simulated ICU environment, we monitored the performance of eight RCPs at baseline and while using the system.Results: Using the system, the time above guideline Pplat decreased by 74% from control, and the time outside the VT range decreased by 60% from control, p = 0.007 and 0.015, respectively. The handoff scores improved quality significantly from 2.8 to 1.6 on a scale of 1 to 5 (1 being best), p = 0.03.Conclusion: In a simulated environment, an electronic RT tool can significantly improve shift-change communication and increase the RCP’s level of LPV adherence.Keywords: respiration, lung protective ventilation, handoff, respiratory therapy, clinical decision support software, health information technology
