Authors (including presenting author) :
Chan KW(1)
Affiliation :
(1)Department of Neurosurgery/High Dependency Unit, Kwong Wah Hospital
Introduction :
For neurosurgical patients admitted to the high dependency unit (HDU), a significant amount of information including vital signs data need to be collected. There is a growing need to improve efficiency in gathering and documenting such data to ensure patient safety, enhance nurse-to-doctor communication as well as to improve clinical workflows. However, the time between vital sign collection and documentation can be lengthy due to numerous factors, including nurse-to-patient care ratios. Health informatics technology can address this issue. In our institution a Clinical Information System (CIS) was adopted for the HDU. The system automatically records blood pressure, heart rate, respiratory rate, oxygen saturation and ventilator parameters’ values. Other patient data such as CVP, arterial BP, EEG are also automatically documented.
Objectives :
This study evaluated nurses’ perceptions of current vital signs collection and documentation methods.
Methodology :
A structured questionnaire of registered nurses with more than six months experience of providing HDU care was conducted from September to October 2020 at a single institution. Nurses caring for only mechanically-ventilated patients with intracranial pressure monitoring were recruited. The duration of time required to collect and document vital signs for these patients using either the CIS or by conventional means, i.e. by a non-automated, paper-based analog system, was recorded. Participants were also requested to provide feedback on these respective systems.
Result & Outcome :
20 nursing staff participated in this study. Results showed a significant reduction in time involved in vital signs collection and documentation using the CIS compared to the traditional paper-based method. It saved each nurse nearly 50% of time required for vital signs documentation (paper-based group: 3.3 + 1.8 minutes vs. CIS: 1.4 + minutes 1.1; independent samples t-test p-value: 0.02). There was no significant difference in the time required for vital signs data collection (paper-based group: 6.8 + 3.6 minutes vs. CIS: 5.7 + minutes 3.2; p-value: 0.28). All participants preferred using the CIS over the paper-based system.
The CIS significantly reduced neurocritical patient data documentation times for nurses and was widely accepted by its end-users. Neurocritical care units are encouraged to utilize such systems to reduce nursing workloads.
