Drews and Doig

• Background


  Based on the configurable virtual sign (CVS) display that would help nurses in the rapid detection and identification of physiological deterioration in a patient presenting vital signs graphically and in context with each other, in particular, they would receive:
• Background part 2

  1. Numerical data on the patient's heart rate, blood saturation, and systolic, diastolic and mean arterial blood pressures
  2. Graphically presented trend data for each of the above measures, positioned immediately to the left of each numerical display
  3. Graphically presented data indicating the degree of variability in the patients physiology over time and within this their current state
• Sample

  • 42 registered nurses with critical care training
  • 21 in each condition
  • Mean ages of 44.59 years (ranged 25-64)
  • At least one year of ICU training with a mean amount of ICU experience of (8.48) years
  • 69% female
• Procedure - four clinical scenarios

  1. Early sepsis - given background info that it was 24hr following a heart valve replacement
  2. Septic shock - given background info it was 48hr following a small bowel resection, remains mechanically ventilated
  3. Pulmonary embolus - Advanced age (79 years), 6 days following a hip replacement, developed pneumonia and mechanically ventilated
  4. Stable scenario - no background info
• Procedure

  • Participants were presented with four scenarios
  • They were instructed to verbally evaluate each patient's physiology status, interpret the data and recommend appropriate interventions as accurately as possible
  • They were given five minutes to complete each scenario
  • Half of the participants (experimental condition) received information on the patients via configural vital information signs (CVS) while the other half (the control condition) received it via traditional ICU display
• Procedure pt 2

  • The dependent measures in the study were (1) the scenario to when the participant delivered verbalisation of assessment and (2) the accuracy of interpretation
  • Scenario presentation was randomised in order to keep things the same for each condition
  • On completion of all four scenarios, all participants were asked to complete self-report questionnaires on the tasks
• Results

  • With regard to response time. participants using CVS were 48% quicker than participants in the control display condition in the septic shock condition
  • They were 38% quicker in pulmonary embolism scenario
  • Accuracy improved by 1.3 using the CVS display in relation to the septic shock and pulmonary embolism scenarios
  • Nurses reported significantly lower mental demand in CVS scenario (mean = 3.95) than in the control condition (mean 4.71)