In the Intensive Care Unit doctors and nurses must make decisions that involve integration of massive amounts of data that is constantly changing. To cope with all this data they rely on monitors that beep and buzz alerting medical staff when a patient needs attention. At University of Utah Hospital, bedside monitoring is being taken to a whole new level thanks to groundbreaking new software.
Currently, best care of brain and spinal cord injured patients involves following standard of care guidelines that espouse treatment thresholds. These thresholds suggest specific values for blood pressure, brain pressure or other parameters which are designed to optimize nutrient delivery to the injured brain or spinal cord. Compliance with these thresholds has been associated with improved outcomes. However, maintaining compliance with these thresholds can be difficult. With this new software, currently in beta testing, doctors and nurses are provided with real-time feedback on threshold compliance for several parameters concurrently.
The software is the brain child of Gregory Hawryluk, MD, PhD, a neurosurgeon specializing in traumatic brain and spinal cord injuries. “We're not only utilizing new and groundbreaking technologies that others have developed, we are inventing new technologies here at the University of Utah. In our intensive care unit we are using technologies that no one else for a long ways away has. Our new software—no one else has it yet.” Hawryluk says.
A major advantage of the new software is that it provides real time data to the medical team and doctors from anywhere in the world. They can access the data remotely and intervene in a patient’s care if necessary. “This is a real paradigm shift. The idea of a doctor being in a different time zone and contributing to a patient’s care as if they were sitting at their bedside is a game changer,” Hawryluk says.
When a patient suffers a traumatic brain or spinal cord injury, the doctors’ primary concern is making sure enough nutrients are getting to the brain or the spinal cord. This software allows doctors to select specific patient variables they want to monitor at the same time. The care team is provided with trend data as well as pie charts which report threshold compliance in real time. This provides invaluable information about the patient’s condition and scrutiny of the treatment provided.
The pie charts reporting threshold compliance, provide nurses with key and previously unavailable feedback on the quality of the care they provided during their shift. Hawryluk adds they have had good buy in from nurses because they realize it helps raise the level of care.
“This software allows us to closely monitor our most acutely ill patients and eliminates any delays of administering care. It’s great to know that both nurse and physicians are seeing the same trends in real time, and can implement interventions to improve the care that is being provided,” says Tyler Harman, clinical nurse coordinator.
The software has also proven to be a time saver for medical staff. In the past to get similar data, doctors and nurses had to go to the patient’s bedside and generate a printout. Nurses would then tape the printout to a wall by the bedside. The presented data and displays could not be modified and this was too laborious to do routinely. As well, the data was immediately outdated from the time it was printed. “This software is a huge advance. Doctors don’t have to walk to the unit and nurses don't have to generate a printout. This software can be anywhere you are and it continuously updates with new data,” Hawryluk says.
Another problem the software solves is it reduces the possibility of misinterpreting the data. When doctors discuss patient care over the phone they must normally rely on others to describe the patient’s condition. This software changes that paradigm. “Rather than relying on another persons’ interpretation of the data, I can just look at the data and make my own impressions,” Hawryluk says.
The software is currently being used for traumatic brain and spinal cord injuries, but Hawyrluk notes other doctors will find this software very helpful in treating other conditions.