title: Evaluation of an integrated intensive care unit monitoring display by critical care fellow physicians.
abstract: In the past two far-view displays, which showed vital signs, trends, alarms, infusion pump status, and therapy support indicators, were developed and assessed by critical care nurses (Görges et al. in Dimens Crit Care Nurs. 30(4):206-17, 2011). The aim of the current study is to assess the generalizability of these findings to physicians. The first aim is to test whether an integrated far-view display, designed to be readable from 3 to 5 m, enables critical care physicians to more rapidly and accurately (1) recognize a change in patient condition; (2) identify alarms; and (3) identify near-empty infusion pumps, than a traditional patient monitor and infusion pump. A second aim is to test if the new displays reduce the mental workload required for this decision making. Fifteen critical care fellow physicians (median age of 34 years, with 2-8 years of ICU experience) were asked to use the three displays to compare the data from two patients and decide which patient required their attention first. Each physician made 60 decisions: 20 with each of the two far-view displays and 20 decisions with a standard patient monitor next to an infusion pump. A 41 and 26 % improvement in decision accuracy was observed with the bar and clock far-view displays, respectively. Specifically, the identification of near empty infusion pumps, a task normally performed by nurses, and patients with a single alarm were better with the new displays. Using the bar display physicians made their decision 12 % faster than when using the control display, a median improvement of 2.1 s. No significant differences were observed in measured workload. Displays that present patient data in a redesigned format enables critical care clinicians to more rapidly identify changes in patient conditions and to more accurately decide which patient needs their attention. In a clinical setting, this could improve patient safety. In future work, an evaluation of the display using live patient data from an ICU should be performed.
authors.affiliation: Electrical and Computer Engineering Department, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada. matthias@abl.med.utah.edu
authors.forename: Matthias
authors.initials: M
authors.lastname: Görges
authors.forename: Dwayne R
authors.initials: DR
authors.lastname: Westenskow
authors.forename: Boaz A
authors.initials: BA
authors.lastname: Markewitz
mesh_terms: D000328:Adult; D056902:Clinical Alarms; D003422:Critical Care; D003626:Data Display; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D010820:Physicians; D013041:Specialties, Nursing; D012122:Ventilators, Mechanical