Hand-held devices may be better for QI projects
Hand-helds simplify data collection
Hand-held devices are a "superior alternative" to manual data collection and entry for quality improvement projects in medical intensive care units (MICU), according to authors of a study presented recently at the 67th annual scientific meeting of the American College of Chest Physicians (ACCP) in Philadelphia.
The pilot project found that the use of a hand-held device simplifies data collection, eliminates manual data entry, and provides prompt availability of information on MICU practice patterns, protocol compliance, drug utilization, and ventilator days that facilitate process improvement.
Barry Fuchs, MD, medical director of the MICU at the University of Pennsylvania Medical Center in Philadelphia, says the study demonstrates the effectiveness of hand-held devices to improve data collection and entry in an MICU. "In addition, these devices make the evaluation of protocol compliance and effectiveness much more efficient."
The project followed 64 mechanically ventilated patients for a total of 697 ventilator days. A sedation protocol was used as the prototype and converted into an electronic data collection form for hand-held devices. The MICU clinical pharmacy specialists used the devices to collect data from the ICU flow sheets, medical records, and various computer databases. Each patient was evaluated daily for adherence to the sedation protocol, the amount of sedating agent used, the episodes and treatment of agitation, and ventilator status until patients were off the ventilator. The information was transferred to a computerized database daily via device synchronization.
Initial analysis of the pilot data showed that there was good compliance with the practice change to bolus administration of sedation. However, there was poor compliance with dose minimization and drug-weaning aspects of the protocol. Investigators agree, however, that the use of a hand-held device simplifies data collection, providing readily available information on MICU practice patterns, drug utilization, ventilator days, and many other factors to facilitate process improvement.
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