RT Assistant - handheld patient safety tool for mechanical ventilation

项目摘要 呼吸治疗师（RT）的任务越来越多，以提高为患者提供的护理质量 在高工作量的情况下控制成本的同时进行机械通气。RT面临的挑战包括 持续了解患者-呼吸机相互作用，确保符合最佳实践 协议，并在换班期间提供有效的通信。虽然新技术最近 为了改善医疗记录文件，缺乏创新的电子工具， 提高对呼吸护理最佳实践和沟通的依从性。 在第一阶段的赠款，我们成功地建立和评估了一个功能齐全的原型系统，称为RT 提供对通气患者的持续远程监测的助手。该设备提供了真实的时间 管理指南、患者安全指南和最佳临床实践，以及标准化的交接 沟通工具。第一阶段原型的设计是为了评估该工具的可行性及其 整合到RT的工作流程中。第二阶段的工作将增加功能，提高数据安全性，增加可用性， 并允许为每个医院或单位定制用户界面。第二阶段系统将促进 将在3家不同的医院进行3项临床试验。RT助理将作为 未来模块化升级的平台，将提供针对呼吸系统的临床决策支持（CDS） 在乎在第二阶段，我们提出两个具体目标。 目标1 -生产RT Assistant系统 为了解决可用性和商业化的问题，这一目标将涉及三类改进 RT助手首先，实施并验证适当的数据安全和IT要求， 允许在医疗环境中安全运行。第二，通过添加额外的 氧合CPG、支持低敏度通气以及支持部门质量的管理功能 考核第三，通过允许针对不同医院定制系统来增加易用性， ICU和支持在不同平台上使用。 目的2 -评价RT Assistant在多中心临床试验中的有效性 为了评估系统在不同环境中的有效性，我们将在两个ICU中评估系统 两个不同的医院。将收集1个月的基线数据，然后收集数据， RT使用RT Assistant 1个月。干预前后数据的统计分析包括 及时患者超出CPG，轮班报告的质量和RT满意度评分，同时使用 系统 在第二阶段拨款完成后，我们将创建一个安全、廉价、直观、功能强大的 该系统已被证明：提高对CPG的合规性、改善轮班报告沟通并增强 情境意识，从而改善患者护理并减少医疗错误。临床结果将 提供数据，使早期采用者能够销售RT Assistant系统。

PROJECT SUMMARY Respiratory Therapists (RTs) are increasingly tasked to improve the quality of care provided for their patients on mechanical ventilation while controlling cost amidst a high workload. Challenges for the RTs include maintaining continuous awareness of patient-ventilator interactions, assuring compliance with best practice protocols, and providing efficient communication during shift changes. While new technology has been recently introduced to improve medical record documentation, there is a scarcity of innovative electronic tools that can improve compliance with best practices and communications in respiratory care. In Phase I of the grant we successfully built and evaluated a fully-functional prototype system called RT Assistant that provides continuous remote monitoring of ventilated patients. The device provides real time management guidelines, guidance on patient safety and best clinical practices, and a standardized hand-off communication tool. The Phase I prototype was designed to evaluate the feasibility of the tool and its integration into an RT's workflow. Phase II effort will add functionality, improve data security, increase usability, and allow for customized user interfaces for each hospital or unit. The Phase II system will facilitate commercialization and will be tested in 3 clinical trials at 3 different hospitals. RT Assistant will serve as a platform for future modular upgrades that will provide clinical decision support (CDS) tailored for respiratory care. In Phase II, we propose two specific aims. Aim 1 – Productize the RT Assistant system To address usability and commercialization concerns, this aim will address three categories of improvements to RT Assistant. First, implement and validate appropriate data security and IT requirements in order to be allowed to operate safely in a healthcare environment. Second, increase functionality by adding an additional oxygenation CPG, support low acuity ventilation, and management features that support departmental quality assessment. Third, increase ease of use by allowing customization of the system for different hospitals and ICUs and enable use on different platforms. Aim 2 – Evaluate effectiveness of RT Assistant in multi-center clinical trial To evaluate the effectiveness of the system in different environments, we will evaluate the system in two ICUs from two different hospitals. Baseline data will be collected for 1 month and then data will be collected while RTs use the RT Assistant for 1 month. Statistical analyses of pre- and post-intervention data includes change in time patients are outside the CPGs, quality of shift reports, and RT satisfaction scores while using the system. After completion of this Phase II grant, we will have created a secure, inexpensive, intuitive, highly functional system proven to: increase compliance with CPGs, improve shift report communication, and enhance situational awareness, resulting in improved patient care and reduced medical errors. The clinical results will provide data that will enable early adopter sales for the RT Assistant system.