Use of a novel electronic maternal surveillance system to generate automated alerts on the labor and delivery unit.
Background: Maternal early warning systems reduce maternal morbidity. We developed an electronic maternal surveillance system capable of visually summarizing the labor and delivery census and identifying changes in clinical status. Automatic page alerts to clinical providers, using an algorithm deve...
| Publicado en: | BMC Anesthesiology Vol. 18; no. 1 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
BioMed Central
6/26/2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130351112&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 130351112 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712253 1CH3 jtl: BMC Anesthesiology issn: 14712253 maglogo: N pubinfo: dt: 6/26/2018 vid: 18 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 130351112 130351112 130351112 10.1186/s12871-018-0540-6 130351112 ppct: 1 formats: tig: atl: Use of a novel electronic maternal surveillance system to generate automated alerts on the labor and delivery unit. aug: au: Klumpner, Thomas T. Kountanis, Joanna A. Langen, Elizabeth S. Smith, Roger D. Tremper, Kevin K. affil: Department of Anesthesiology University of Michigan 1H247 University Hospital, 1500 East Medical Center Drive 48109-5048 Ann Arbor MI USA sug: subj: Risk Management Wearable Sensors Hospital Units Monitoring, Physiologic Methods Human Male Female Algorithms Vital Signs Hypertension Tachycardia Treatment Outcomes Male Female ab: Background: Maternal early warning systems reduce maternal morbidity. We developed an electronic maternal surveillance system capable of visually summarizing the labor and delivery census and identifying changes in clinical status. Automatic page alerts to clinical providers, using an algorithm developed at our institution, were incorporated in an effort to improve early detection of maternal morbidity. We report the frequency of pages generated by the system. To our knowledge, this is the first time such a system has been used in peripartum care. Methods: Alert criteria were developed after review of maternal early warning systems, including the Maternal Early Warning Criteria (MEWC). Careful consideration was given to the frequency of pages generated by the surveillance system. MEWC notification criteria were liberalized and a paging algorithm was created that triggered paging alerts to first responders (nurses) and then managing services due to the assumption that paging all clinicians for each vital sign triggering MEWC would generate an inordinate number of pages. For preliminary analysis, to determine the effect of our automated paging algorithm on alerting frequency, the paging frequency of this system was compared to the frequency of vital signs meeting the Maternal Early Warning Criteria (MEWC). This retrospective analysis was limited to a sample of 34 patient rooms uniquely capable of storing every vital sign reported by the bedside monitor. Results: Over a 91-day period, from April 1 to July 1, 2017, surveillance was conducted from 64 monitored beds, and the obstetrics service received one automated page every 2.3 h. The most common triggers for alerts were for hypertension and tachycardia. For the subset of 34 patient rooms uniquely capable of real-time recording, one vital sign met the MEWC every 9.6 to 10.3 min. Anecdotally, the system was well-received. Conclusions: This novel electronic maternal surveillance system is designed to reduce cognitive bias and improve timely clinical recognition of maternal deterioration. The automated paging algorithm developed for this software dramatically reduces paging frequency compared to paging for isolated vital sign abnormalities alone. Long-term, prospective studies will be required to determine its impact on patient outcomes. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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