Exploring Clinical Practices of Critical Alarm Settings in Intensive Care Units: A Retrospective Study of 60,000 Patient Stays from the MIMIC-IV Database.
In Intensive Care Unit (ICU), the settings of the critical alarms should be sensitive and patient-specific to detect signs of deteriorating health without ringing continuously, but alarm thresholds are not always calibrated to operate this way. An assessment of the connection between critical alarm...
| Publicado en: | Journal of Medical Systems Vol. 48; no. 1; pp. 1 - 10 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
9/16/2024
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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=180518328&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 180518328 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01485598 4N0 jtl: Journal of Medical Systems issn: 01485598 maglogo: N pubinfo: dt: 9/16/2024 vid: 48 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 180518328 180518328 180518328 10.1007/s10916-024-02107-6 180518328 ppf: 1 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Exploring Clinical Practices of Critical Alarm Settings in Intensive Care Units: A Retrospective Study of 60,000 Patient Stays from the MIMIC-IV Database. aug: au: Carencotte, Remi Oliver, Matthieu Allou, Nicolas Ferdynus, Cyril Allyn, Jérôme affil: Clinical Informatics Department, Saint-Denis University Hospital, Saint-Denis, Reunion Island, France sug: subj: Monitoring, Physiologic Methods Intensive Care Units Administration Equipment Alarm Systems Evaluation Medical Practice Patient Safety Outcomes (Health Care) Human Male Female Middle Age Aged Retrospective Design Descriptive Research Exploratory Research Prospective Studies Record Review Artificial Intelligence Descriptive Statistics Random Forest Vital Signs Middle Aged: 45-64 years Aged: 65+ years Male Female ab: In Intensive Care Unit (ICU), the settings of the critical alarms should be sensitive and patient-specific to detect signs of deteriorating health without ringing continuously, but alarm thresholds are not always calibrated to operate this way. An assessment of the connection between critical alarm threshold settings and the patient-specific variables in ICU would deepen our understanding of the issue. The aim of this retrospective descriptive and exploratory study was to assess this relationship using a large cohort of ICU patient stays. A retrospective study was conducted on some 70,000 ICU stays taken from the MIMIC-IV database. Critical alarm threshold values and threshold modification frequencies were examined. The link between these alarm threshold settings and 30 patient variables was then explored by computing the Shapley values of a Random Tree Forest model, fitted with patient variables and alarm settings. The study included 57,667 ICU patient stays. Alarm threshold values and alarm threshold modification frequencies exhibited the same trend: they were influenced by the vital sign monitored, but almost never by the patient's overall health status. This exploratory study also placed patients' vital signs as the most important variables, far ahead of medication. In conclusion, alarm settings were rigid and mechanical and were rarely adapted to the evolution of the patient. The management of alarms in ICU appears to be imperfect, and a different approach could result in better patient care and improved quality of life at work for staff. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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