RT Assistant - handheld patient safety tool for mechanical ventilation

项目总结 呼吸治疗师(Rt)的任务越来越多，以提高为他们的病人提供的护理质量。 在高工作量的情况下控制成本的同时进行机械通风。RTS面临的挑战包括 持续了解患者与呼吸机的相互作用，确保符合最佳实践 协议，并在换班期间提供高效的通信。虽然新技术最近才出现 为改进病历记录而引入的，目前还缺乏能够 改善呼吸护理方面的最佳做法和沟通的遵从性。 在赠款的第一阶段，我们成功地构建并评估了一个名为RT的全功能原型系统 为呼吸机患者提供持续远程监护的助手。该设备提供实时 管理指南、关于患者安全和最佳临床实践的指导以及标准化交接 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和它的 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，增加可用性， 并允许为每个医院或单位定制用户界面。第二期系统将促进 并将在3家不同医院的3项临床试验中进行测试。RT Assistant将作为 用于未来模块化升级的平台，将提供针对呼吸系统量身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辅助系统产品化 为了解决可用性和商业化问题，这个目标将解决三类改进 转到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运行。第二，通过添加额外的 氧合CPG，支持低视力通风，以及支持部门质量的管理功能 评估。第三，允许为不同医院定制系统，从而提高易用性 ICU，并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效果 为了评估系统在不同环境中的有效性，我们将在两个ICU中对系统进行评估 来自两家不同的医院。将收集1个月的基线数据，然后在 RTS使用RT助手1个月。干预前和干预后数据的统计分析包括变化 患者在CPG之外的时间、轮班报告的质量以及使用 系统。 在完成此第二阶段拨款后，我们将创建一个安全、廉价、直观、功能强大的 经过验证的系统：提高对CPG的遵从性，改善轮班报告沟通，并增强 情景感知，从而改善患者护理并减少医疗差错。临床结果将会 提供将促进RT Assistant系统的早期采用者销售的数据。

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.