ARDS, Mechanical Ventilation, Quality Improvement, Respiratory Failure, Ventilation, Ventilator Associated Events, Ventilator-induced Lung Injury (VILI)
Conditions
Keywords
Computer aided mechanical ventilation, Mechanical ventilation quality, Mechanical ventilation, Mechanical ventilation safety, Ventilator monitoring application
Brief summary
Ventilator associated events (VAE) is a quality metric defined by 48 hours of stability followed by 48 hours of escalation of ventilator settings within the ICU. VAE have been associated with poor outcomes and increases the cost of care, yet is not easy to avoid. Operationalizing all the standards of care known to improve outcomes of those requiring mechanical ventilation in the critical care environment requires a comprehensive approach. ICU teams are encouraged to follow best practice protocols to help liberate and prevent VAEs. Yet, compliance with protocols in most ICUs is suboptimal for multiple reasons. With the advent of computerized mechanical ventilators capable of streaming data from breath to breath and biomedical integration systems (BMDI) such as Capsule (UTMB's BMDI system), software systems have been developed to help identify variances in the standard of care. Automation in near real-time ventilator data feedback has been shown to reduce the incidences of VAEs. This quality improvement project will leverage Vyaire's Respiratory Knowledge Portal (RKP) to collect and store meaningful data regarding ventilator-associated events (VAE), alarm policy compliance, ventilator weaning, and lung protective analytics. Goals: 1. To collect quality metrics utilizing RKP from patients requiring mechanical ventilation over a 3-4-month period for a retrospective baseline analysis. 2. Provide the RKP tool to the ICU team to determine if the use of RKP's webportal and Messenger Zebra phone app improves quality of mechanical ventilation and outcomes. 3. To determine a return on investment (ROI) for a software system like RKP.
Interventions
OTHERRKP Monitoring Software
Use of RKP alerting and monitoring software.
Sponsors
The University of Texas Medical Branch, Galveston
Vyaire Medical
Zoll Medical Corporation
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Masking description
Monitoring 3-4 months prior to intervention or use of the software.
Eligibility
Sex/Gender
ALL
Age
No minimum to 100 Years
Healthy volunteers
No
Inclusion criteria
1. Subjects requiring invasive mechanical ventilation. 2. Subjects is in one of the monitored Galveston campus ICUs. 3. Ages 0-100
Exclusion criteria
1. Is in an ICU not monitored by RKP. 2. Adults on high frequency ventilation (pediatric patients are NOT excluded). 3. Any patient requiring ECMO.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of participants with Ventilator-Associated Events | 3-4 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Ventilator Alarm Set Outside of Compliance | 3-4 months | Ventilator alarms set by the RT |
| Duration of Days on mechanical ventilation | 3-4 months | Does the weaning of mechanical ventilation improve through the measurements of spontaneous breathing trials. |
Countries
United States
Outcome results
None listed