Heart Rate Variability for Practitioner Stimulated Reflection and Decision-making Optimisation
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 20
- 试验地点
- 2
- 主要终点
- Reduction in response time to ventilator patient physiological alarms
研究概览
简要总结
At the heart of healthcare is the interaction between healthcare practitioners and patients. It is believed that optimisation of this interaction can improve patient relevant outcomes, safety and patient experience. Through utilisation of practitioner physiological data, heart rate variability (HRV), to help practitioners make better decisions and optimise practice, it is considered possible to improve decision making around patient care and improve outcomes and safety.
The modern intensive care unit (ICU) is a dynamic data rich environment requiring rapid and accurate decision making. Advances in ventilator technology, electronic patient monitoring and electronic health records (EHR) have provided exponential growth in data produced for patients and the need for complex decision making. However, data overload and alarm fatigue can result in poor understanding and a delayed response from the practitioner in addressing the patient's needs.
The aim of this study is to present and evaluate a psychophysiology training approach for practitioners derived from their cardiovascular response through the course of the working day, this will be measured using heart rate variability (HRV). Practitioner HRV has been shown to be linked to work related stress and is considered a biomarker of decision-making.
详细描述
A Critical Participatory Action Research learning model is proposed, whereby practitioners can explore the nature and consequences of their practice utilising their HRV during two intervention periods. The aim is to improve practitioner performance and develop a more context aware approach to patient care.
Impact will be measured through:
- improvement in HRV of the practitioners
- measurement of response times to ventilator related events (decreased response times)
- improvement of time spent at bedside
- improvement in ventilation related outcomes for the patients.
- Reduction in bedside noise (reduced response time to alarms and reduction in inappropriate alarms)
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 21 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Nurse working in Enhanced Recovery Unit at Royal Papworth Hospital NHS Foundation Trust
- •Willingness to participate in the trial
排除标准
- •Staff with permanent pacemakers
- •Staff on medication that could affect HRV (e.g. b-blockers)
研究组 & 干预措施
Bedside nurses in Enhanced Recovery Unit
Baseline collection will consist of data from 20 bedside nurses over 10 shifts (12 hours +/- 3 hrs) each. 5 shifts post first intervention (1st workshop) and 5 shifts post second intervention (2nd workshop).
干预措施: Critical Participatory Action Intervention with HRV Feedback (Behavioral)
结局指标
主要结局
Reduction in response time to ventilator patient physiological alarms
时间窗: At completion of 20th clinical shift (each shift is 12 hours)
Practitioner response time (in seconds) to ventilator-related physiological alarm events measured using ventilator event logs and bedside monitoring system records.
Adherence to bedside noise level targets
时间窗: At completion of 20th clinical shift (each shift is 12 hours)
Duration of time (seconds) bedside noise levels remain outside predefined acceptable clinical thresholds, measured using bedside environmental noise monitoring during clinical shifts.
次要结局
- Improvement in practitioner heart rate variability during clinical practice(At completion of 20th clinical shift (each shift is 12 hours))
- Participant-reported work effectiveness, job satisfaction, and stress levels(At completion of 20th clinical shift (each shift is 12 hours))