Improving Outcomes for Mechanically Ventilated Patients With the Digital EZ Board
Overview
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Ohio State University
- Enrollment
- 147
- Locations
- 1
- Primary Endpoint
- Mean Daily Patient-reported Communication Difficulty Rating Using Single Item 0-4 Rating Scale
Overview
Brief Summary
This Phase II Small Business Technology Transfer Research (STTR) will deliver a comprehensive patient communication solution for communication-impaired patients in the intensive care unit that may help decrease days in delirium, decrease anxiety levels, and reduce sedation exposure which are proximal outcomes known to be associated with decreased mechanical ventilation days, shorter lengths of ICU and hospital stay, and lower healthcare cost. The primary goal of this Phase II STTR proposal is to further define user requirements and product specifications and develop a prototype of VidaTalk, a patient-centric, touch pad communication software, to provide mechanically ventilated (MV) patients an evidence-based solution for effectively communicating their needs to care providers and family. A secondary goal is to test the impact of the VidaTalk on clinical outcomes. This study will use mixed methods including observations and interaction with hospitalized patients as they use the VidaTalk tool, surveys and medical record data extraction, product evaluation and brief interview, satisfaction surveys with family members of ICU patients, and focus groups with Registered Nurses.
Specific Aim 1. Develop a commercial prototype of VidaTalk that will include multilingual and customizable messages, compatibility with tablet devices, picture symbols, and integration with mobile communication devices.
Specific Aim 2. Demonstrate usability with iterative user assessment testing in a clinical setting.
Specific Aim 3. Test the clinical efficacy of VidaTalk via android application with MV patients by examining qualitative and quantitative endpoints in a clinical setting. Aim 3 hypothesis: MV patients using VidaTalk will demonstrate significant reductions in patient-reported communication difficulty and frustration, anxiety, sedation exposure, delirium/coma-free days, and improved patient and family satisfaction with ICU care compared to MV patients receiving attention-control (i.e., tablets with health education application).
Specific Aim 4. Validation of electronic visual analogue scale, versus current standard paper scale.
Specific Aim 5 a, b and c. Test the effect of the communication tablet (VidaTalk) on psychological symptoms in family caregivers.
Detailed Description
Treatment-induced communication impairment is one of the most common and distressful symptoms to mechanically ventilated intensive care unit (ICU) patients and is associated with anxiety, panic, anger, frustration, sleeplessness, and distress.This Phase II Small Business Technology Transfer Research (STTR) will deliver a comprehensive solution that may help decrease days in delirium, decrease anxiety levels, and reduce sedation exposure which are proximal outcomes known to be associated with decreased mechanical ventilation days, shorter lengths of ICU and hospital stay, and lower healthcare cost. The primary goal of this Phase II STTR proposal is to further define user requirements and product specifications and develop a prototype of VidaTalk (previously TouchTalk), a patient-centric, touch pad communication software, to provide mechanically ventilated (MV) patients an evidence-based solution for effectively communicating their needs to care providers and family. A secondary goal is to test the impact of the VidaTalk on clinical outcomes (e.g., patient-reported communication difficulty and frustration, anxiety, sedation exposure, delirium/coma-free days, and improved patient and family satisfaction with ICU care). This study will use mixed methods including observations and interaction with hospitalized patients as they use the VidaTalk communication tool, surveys and medical record data extraction, product evaluation and brief interview, satisfaction survey with family members of ICU patients and focus groups with Registered Nurses. Our Phase I STTR successfully delivered a beta prototype that met technical feasibility criteria; however, additional requirements emerged as a common theme from user testing and market analysis. The current study will meet the identified needs for VidaTalk to operate on android devices, be customizable to patients' unique message needs, use pictures symbols for communication, and be able to route patient requests to providers who are not present at the bedside.
Specific Aim 1 (Preliminary to Clinical Trial). Develop a commercial prototype of VidaTalk that will include multilingual and customizable messages, compatibility with tablet devices, picture symbols, and integration with mobile communication devices.
Specific Aim 2 (Preliminary to Clinical Trial). Demonstrate usability with iterative user assessment testing in a clinical setting.
Specific Aim 3. Test the clinical efficacy of VidaTalk via android application with MV patients by examining qualitative and quantitative endpoints in a clinical setting. Aim 3 hypothesis: MV patients using VidaTalk will demonstrate notable reductions in patient-reported frustration and communication difficulty, anxiety, sedation exposure, delirium/coma-free days, and improved patient and family satisfaction with ICU care compared to MV patients receiving attention-control.
Specific Aim 4. Validation of electronic visual analogue scale, versus current standard paper scale.
Specific Aim 5. Test the effect of the communication tablet (VidaTalk) on psychological symptoms in family caregivers.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Supportive Care
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 99 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •≥18 years old
- •Able to communicate in English
- •Awake alert, responding appropriately to commands.
- •Normal (aided or unaided) hearing and vision
- •Able to control head, arm and hand movements
- •Physiologically stable and in no acute distress (per nurse report)
Exclusion Criteria
- •Pre-existing communication impairments
- •Diagnosis of severe dementia or brain injury
- •CAM-ICU positive for delirium
- •unresponsiveness or inattention
- •Inclusion Criteria:
- •≥18 years old
- •Able to communicate in English
- •Awake alert, responding appropriately to commands.
- •Normal (aided or unaided) hearing and vision
- •Able to control head, arm and hand movements
Outcomes
Primary Outcomes
Mean Daily Patient-reported Communication Difficulty Rating Using Single Item 0-4 Rating Scale
Time Frame: Daily post-randomization until extubation or ICU discharge up to maximum of 28 days in the ICU
Aim 3 - Mean item score of daily by patient self report using a single item Likert-type scale from the Ease of Communication Scale (ECS) where scores range from 0 "not hard at all" to 4 "extremely hard"
Secondary Outcomes
- Mean Patient Frustration With Communication(Daily post-randomization until extubation or ICU discharge up to maximum of 28 days in the ICU)
- Family Satisfaction With Care in the Intensive Care Unit FS-ICU(One 10 minute survey will be given at patient's ICU discharge or extubation)
- Mean Patient Reported Anxiety Score Using Visual Analogue Scale(Daily post-randomization until extubation or ICU discharge up to maximum of 28 days in the ICU)
- Percentage of Patients Scoring in the "Calm" Range During Study Days on Richmond Agitation Sedation Score(Daily post-randomization until extubation or ICU discharge up to maximum of 28 days in the ICU)
- Electronic Visual Analogue Scale-validation Measure(Only measured at baseline, order of administration randomized before or after paper version)
- Family Member Anxiety(Baseline, patient extubation or discharge from ICU, 1-month, 3-month, 6-month post-discharge)
- Family Member Depression(Baseline, patient extubation or discharge from ICU, 1-month, 3-month, 6-month post-discharge)
- Family Communication Difficulty(baseline and extubation or discharge from the ICU)
- Communication Task Error Rate(Measured during 30-60 minute usability testing visit which occurs at study completion. This outcome applies only to Aim 1 & 2 arms.)
- Ease of Communication at Extubation /ICU Discharge(measured at Extubation /ICU Discharge)
- Mean Daily Sedation Exposure(Daily post-randomization until extubation or ICU discharge up to maximum of 28 days in the ICU daily in ICU)
- Delirium/Coma -Free Days(Daily, from enrollment to 28 days post-enrollment)
- Patient Satisfaction With Care(Measured at extubation or discharge from ICU which ever comes first)
- Post-traumatic Stress Symptoms: Impact of Events Scale-revised (IES-R)(1-month, 3-month, 6-month post-discharge)
- Patient Satisfaction With Communication Task Ease(Measured during 30-60 minute usability testing visit which occurs at study completion)
- After-Scenario Questionnaire (ASQ) Score(Measured during 30-60 minute usability testing visit which occurs at study completion)
- Total Error Rate(Measured during 30-60 minute usability testing visit which occurs at study completion)
- Observed Task Completion Time (in Seconds)(Measured during 30-60 minute usability testing visit which occurs at study completion)
- System Usability Scale (SUS) -Adapted(Measured during 30-60 minute usability testing visit which occurs at study completion)
- Number of Participants That Responded "Yes" to Having Communication Difficulty at Extubation or ICU Discharge(measured at Extubation /ICU Discharge)
Investigators
Mary Beth Happ
Associate Dean for Research and Innovation
Ohio State University