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Clinical Requirements of Future Patient Monitoring in the Intensive Care Unit: Qualitative Study

机译：重症监护病房未来患者监测的临床要求：定性研究

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In the intensive care unit (ICU), continuous patient monitoring is essential to detect critical changes in patients' health statuses and to guide therapy. The implementation of digital health technologies for patient monitoring may further improve patient safety. However, most monitoring devices today are still based on technologies from the 1970s. The aim of this study was to evaluate statements by ICU staff on the current patient monitoring systems and their expectations for future technological developments in order to investigate clinical requirements and barriers to the implementation of future patient monitoring. This prospective study was conducted at three intensive care units of a German university hospital. Guideline-based interviews with ICU staff-5 physicians, 6 nurses, and 4 respiratory therapists-were recorded, transcribed, and analyzed using the grounded theory approach. Evaluating the current monitoring system, ICU staff put high emphasis on usability factors such as intuitiveness and visualization. Trend analysis was rarely used; inadequate alarm management as well as the entanglement of monitoring cables were rated as potential patient safety issues. For a future system, the importance of high usability was again emphasized; wireless, noninvasive, and interoperable monitoring sensors were desired; mobile phones for remote patient monitoring and alarm management optimization were needed; and clinical decision support systems based on artificial intelligence were considered useful. Among perceived barriers to implementation of novel technology were lack of trust, fear of losing clinical skills, fear of increasing workload, and lack of awareness of available digital technologies. This qualitative study on patient monitoring involves core statements from ICU staff. To promote a rapid and sustainable implementation of digital health solutions in the ICU, all health care stakeholders must focus more on user-derived findings. Results on alarm management or mobile devices may be used to prepare ICU staff to use novel technology, to reduce alarm fatigue, to improve medical device usability, and to advance interoperability standards in intensive care medicine. For digital transformation in health care, increasing the trust and awareness of ICU staff in digital health technology may be an essential prerequisite. ClinicalTrials.gov NCT03514173; https://clinicaltrials.gov/ct2/show/NCT03514173 (Archived by WebCite at http://www.webcitation.org/77T1HwOzk). ?Akira-Sebastian Poncette, Claudia Spies, Lina Mosch, Monique Schieler, Steffen Weber-Carstens, Henning Krampe, Felix Balzer. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 30.04.2019.
机译：在重症监护室（ICU）中，持续患者监测对于检测患者健康状况和指导治疗的关键变化至关重要。用于患者监测的数字健康技术的实施可能进一步提高患者安全性。然而，今天的大多数监控设备仍然基于20世纪70年代的技术。本研究的目的是评估ICU工作人员对目前患者监测系统的陈述及其对未来技术发展的预期，以调查未来患者监测的临床要求和障碍。这项前瞻性研究是在德国大学医院的三个重症监护室进行的。基于指南的ICU工作人员-5医生，6名护士和4名呼吸治疗师的访谈进行了记录，转录和分析并分析并分析。评估当前的监测系统，ICU员工高重点对直观和可视化等可用性因素。趋势分析很少使用;报警管理不足以及监控电缆的纠缠被评为潜在的患者安全问题。对于未来的系统，再次强调了高可用性的重要性;需要无线，非侵入性和可互操作的监测传感器;需要用于远程患者监控和报警管理优化的手机;基于人工智能的临床决策支持系统被认为是有用的。在实施新技术的实施障碍中，缺乏信任，害怕失去临床技能，担心增加工作量，以及缺乏可用数字技术的认识。这种对患者监测的定性研究涉及ICU工作人员的核心陈述。为促进ICU中的数字健康解决方案的快速和可持续实施，所有医疗保健利益攸关方必须更多地关注用户衍生的调查结果。报警管理或移动设备的结果可用于准备ICU工作人员使用新颖的技术，减少报警疲劳，提高医疗器械可用性，并推进密集护理中的互操作性标准。对于卫生保健的数字转型，增加数字健康技术ICU员工的信任和认识可能是一个必不可少的先决条件。 ClinicalTrials.gov NCT03514173; https://clinicaltrials.gov/ct2/show/nct03514173（由webcite存档在http://www.webccition.org/77t1hwozk）。 ？Akira-Sebastian Poncette，Claudia间谍，Lina Morch，Monique Schieler，Steffen Weber-Carstens，亨宁克鲁普，Felix Balzer。最初发表在JMIR医疗信息学（http://medinform.jmir.org），30.04.2019。

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