RT Assistant - handheld patient safety tool for mechanical ventilation

RT Assistant - 用于机械通气的手持式患者安全工具

• 批准号: 10246664
• 负责人: Neil R. Euliano
• 金额: $ 75.61万
• 依托单位: CONVERGENT ENGINEERING, INC.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-20 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10246664
• 关键词: Address; Adherence; Adult Respiratory Distress Syndrome; Affect; Awareness; COVID-19 pandemic; Caring; Categories; Cessation of life; Chronic; Clinical; Clinical Distribution; Clinical Practice Guideline; Clinical Trials; Communication; Communication Tools; Complex; Critical Illness; Custom; Data; Data Security; Devices; Documentation; Electronics; Environment; Face; Failure; Future; Grant; Guideline Adherence; Guidelines; Hand; Healthcare; Hospitals; Hour; Intervention; Intuition; Life; Life Support Care; Lung; Malpractice; Mechanical Ventilators; Mechanical ventilation; Medical Errors; Medical Records; Methods; Monitor; Multi-Institutional Clinical Trial; Patient Care; Patient-Focused Outcomes; Patients; Phase; Protocols documentation; Publications; Quality of Care; Reporting; Risk; Safety; Sales; Secure; Standardization; Statistical Data Interpretation; Stress; System; Testing; Tidal Volume; Time; Time Management; Ventilator; Ventilator-induced lung injury; Workload; base; care providers; clinical decision support; clinical practice; commercialization; computerized; cost; design; effectiveness evaluation; evidence base; improved; innovation; mortality; new technology; patient safety; post intervention; pressure; prototype; provider adoption; remote monitoring; remote patient monitoring; respiratory; respiratory assist; satisfaction; sound; support tools; tool; uptake; usability; ventilation

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.

项目概要 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 机械通气，同时在高工作量中控制成本。 RT 面临的挑战包括 保持对患者与呼吸机相互作用的持续认识，确保遵守最佳实践 协议，并在换班期间提供有效的通信。虽然最近出现了新技术 为改善医疗记录文档而引入的创新电子工具非常缺乏 提高呼吸护理最佳实践和沟通的合规性。 在资助的第一阶段，我们成功构建并评估了一个名为 RT 的全功能原型系统 为通气患者提供持续远程监控的助手。该设备提供实时 管理指南、患者安全指南和最佳临床实践以及标准化交接 通讯工具。第一阶段原型旨在评估该工具及其可行性 集成到 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，提高可用性， 并允许为每个医院或单位定制用户界面。二期系统将促进 商业化，并将在 3 家不同医院进行 3 项临床试验。 RT Assistant 将作为 未来模块化升级的平台将提供针对呼吸系统定制的临床决策支持（CDS） 关心。在第二阶段，我们提出了两个具体目标。 目标 1 – RT Assistant 系统产品化 为了解决可用性和商业化问题，该目标将解决三类改进 到 RT 助手。首先，实施并验证适当的数据安全和 IT 要求，以便 允许在医疗保健环境中安全操作。其次，通过添加额外的功能来增加功能 氧合 CPG、支持低敏锐度通气以及支持部门质量的管理功能 评估。第三，通过允许为不同的医院和客户定制系统来提高易用性 ICU 并可在不同平台上使用。 目标 2 – 评估 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下的有效性，我们将在两个 ICU 中评估系统 来自两家不同的医院。将收集 1 个月的基线数据，然后在 RT 使用 RT Assistant 1 个月。干预前后数据的统计分析包括变化 患者在 CPG 之外的时间、轮班报告的质量和 RT 满意度评分，同时使用 系统。 完成第二阶段拨款后，我们将创建一个安全、廉价、直观、功能强大的 事实证明，该系统可以：提高对 CPG 的合规性、改善轮班报告沟通并增强 态势感知，从而改善患者护理并减少医疗错误。临床结果将 提供有助于 RT Assistant 系统早期采用者销售的数据。