Presentation is loading. Please wait.

Presentation is loading. Please wait.

Dr Signouret Thomas Alarms Externalisation.  Patients  Vital prognosis committed  Multiorgan failure  Cares :  Invasives, painfull, 24 h/24  Life.

Similar presentations


Presentation on theme: "Dr Signouret Thomas Alarms Externalisation.  Patients  Vital prognosis committed  Multiorgan failure  Cares :  Invasives, painfull, 24 h/24  Life."— Presentation transcript:

1 Dr Signouret Thomas Alarms Externalisation

2  Patients  Vital prognosis committed  Multiorgan failure  Cares :  Invasives, painfull, 24 h/24  Life support equipment: ventilator, dyalisis, infusion pumps  Monitoring: 24 h/24  Caregivers  Monitoring device Intensive care unit

3  Currently average noise: 60 → 70 dB  Alarms : 70 → 80 dB !!!  Staff conversations: 59 → 90 dB Bush-Vishniac J acoust soc Am 2005  10 à 25 % of alarms do induce a therapeutic modification Lawless ST Crit Care Med 1994  Patients:  Disturbance  Tachycardia, hypertension  Pituitary and adrenal gland stimulation Xie Crit care 2009  Nurses: Concentration, stress, Phenomen of alarm fatigue Morrison Crit Care Med 2003 Chambrin MC crit care 2001 Noise: World Health Organisation guidelines: 35 → 40 dB

4  Sleep disturbance:  Slower healing  Cognitive function  Décrease immune response  ICU delirium : 20 →80 %  ↗ lenght of stay  ↗ morbi-mortality Ely EW JAMA 2004  Noise is one of many factors of sleep disturbance:  17→ 56 % Xie Crit care 2009 Link between noise and sleep disturbance ?

5 1.Remove the cardiacs monitor alarms from the room to the centrale station 2.Close the patient door’s room 3.Pb: What about the others devices Alarm’s ? 4.Need a translation of all the alarm in the same language (HL7): Capsultech® 5.Need to bring and allocate the alarm to the caregiver: Connexall® Historic

6  Decrease the noise due to the alarms in the patient room.  Allow the door closing:  Decrease the noise from the nursing station - 4 dB: Lawson Am J Crit Care 2010  Overpressure level respected in the unit  Aspergillose prevention R113: Référentiel struct Vdef 2011  Alarms send to caregivers  Tracability Aims of the Externalisation alarms

7

8  Cardiac arrest(vital priority) : Vital emmergency who need an immediat respons of all the caregivers( nurses and doctor) of intensive care unit  Critical (high priority ) : Urgent situation who require an immediat response of caregivers  Grave (medium priority) : Imminent risk who requires a rapid response of caregivers  Message (low priority) : Attention of medical staff is require European standard medical devices.EN 475:1995 Définition of gravity level

9 Mapping alarms

10 Workflow

11 The Daily Job of the Nurse

12 Hardware connectivity

13 Check devices connexion  Specific connection by DIM Capsultech® on device RS232 outlet  Connection IT wires on DATACAPTOR®module for sending the information on the network

14  Connexall central station:  Assignement of each patient on an iPoD which is dedicated to a nurse Sélect and Assign the patients R2.2R2.1

15 Assignment

16 Connexall Central station Main Screen

17 Alarms on mobile Device Arrêt cardiaque box 1 Acknowledgment

18  Golive on a five beds unit after a training of all nurses of the unit  Connection of all devices  Good expression of the sonor Alarms with right tonality, gravity and workflow  Visual alarms: Good rendering  Doors closed recently  We left the sound in the box due to an IT server issue Currently

19  Log out the devices from the datacaptor  4 or 5 network  Drager  Capsultech  Connexall  Hopital européen Marseille  Apple Regulated Medical Devices Class II FDA Alarm Externalisation Risk

20  A visual indicator of log out on connexall central station  An automatic detection of IT server issue by heart bit then an alarm message with a workflow to:  Drager IT engineer  Biomed  Doctor  Chief nurse  A new device who avoid apple network  Evaluation the quality of caregivers réaction What we expected ? Sécurity

21  Transitory (2min) Inhibition of the transmission of all alarm on the Connexall system when the Nurse active “a nursing function”  Showing the waves in live in case of alarm: Link patient watch  Sending vocal message with:  1 st : the sound characteristic of level of gravity  2 nd : the number of room  3 rd : the message of alarm And Also…: Dévellopment

22 Link on patient watch

23 Evaluation 1.Safety 2.Efficacy 3.Perception

24 Safety  Description of differents alarm :  Number of alarm / hour and /12 h  Number by device  Number by nurse  Number by gravity  Delay between alarm and acknowledgment  Delay between alarm and resolution

25 Efficacy  Average intensity noise during day and night :  In the room  In the nurse station  Number of Peak level > 80 dB/ h during day and night :  In the room  In the nurse station

26 Perception  Patient questionnaire :  Sleep quality : Richards Campbell Sleep Questionnaire  Noise discomfort  Care givers quetionnaire :  Noise discomfort  Satisfaction

27 Primary purpose: réduction of 10 dB by currently average noise level 60 +/- 10 dB We need 16 patients in each stategies Power: 80 % alpha risk : 5 % A prospective open interventionnel study évaluate a reducing stratégy of noise by an alarm notification system

28  Extended the externalisation of the alarm to other medical Device  ECMO, Bed, Labs, etc…  Extended the externalisation of the alarm to other medical specialties  Anesthesia : An anesthesiologist works on several OR  Cardiology  Special device to show the alarm: Samsung gear, Google Glasses Middle and Long terms Plan

29 Thank you for you attention

30 Functionnal Basics of Third-Party Alarm Notification Systems B Moorman Biomed Instrumentation and Technology 2011


Download ppt "Dr Signouret Thomas Alarms Externalisation.  Patients  Vital prognosis committed  Multiorgan failure  Cares :  Invasives, painfull, 24 h/24  Life."

Similar presentations


Ads by Google