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Evaluation of compliance with a computerized protocol: weaning from mechanical ventilator support using pressure
A G Randolph1, T P Clemmer, T D East
1Division of Pulmonary Medicine, LDS Hospital, University of Utah, Salt Lake City 84143, USA.
Computer Methods and Programs in Biomedicine
|November 21, 1998
Summary
This study shows high user compliance with a computerized mechanical ventilator weaning protocol. The system effectively monitored adherence and non-adherence reasons, proving its reusability for mechanical ventilation management.
Area of Science:
- Critical Care Medicine
- Respiratory Therapy
- Health Informatics
Background:
- Mechanical ventilation weaning protocols are crucial for patient recovery.
- Optimizing weaning protocols can reduce mechanical ventilation duration.
- Computerized systems offer potential for protocol adherence monitoring.
Purpose of the Study:
- To assess the feasibility of a computerized system for a mechanical ventilator weaning protocol.
- To evaluate the use of the rapid shallow breathing index for pressure support adjustments.
- To develop a system for monitoring user compliance and non-compliance reasons.
Main Methods:
- Nine critically ill patients (ten weaning episodes) were included in the protocol.
- Respiratory therapists used a computerized system for charting and protocol instructions.
- The system monitored instruction acceptance, implementation, and reasons for non-compliance.
Main Results:
- Patient therapy was protocol-controlled for 1075 hours.
- Clinical staff followed 94.8% of protocol instructions.
- Reasons for non-compliance included extubation decisions and system errors.
Conclusions:
- A high level of user compliance was achieved with the computerized weaning protocol.
- The compliance monitoring methods are reusable for mechanical ventilation and other domains.