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Enhancing prehospital decision-making: exploring user needs and design considerations for clinical decision support systems.
BMC Med Inform Decis Mak
January 2025
School of Medicine, University of Colorado, Aurora, CO, USA.
Background: In prehospital emergency care, providers face significant challenges in making informed decisions due to factors such as limited cognitive support, high-stress environments, and lack of experience with certain patient conditions. Effective Clinical Decision Support Systems (CDSS) have great potential to alleviate these challenges. However, such systems have not yet been widely adopted in real-world practice and have been found to cause workflow disruptions and usability issues.
View Article and Find Full Text PDFContinuous vital sign monitoring of patients recovering from surgery on general wards: a narrative review.
Br J Anaesth
January 2025
Perioperative Outcomes and Informatics Collaborative, Winston-Salem, NC, USA; Outcomes Research Consortium, Houston, TX, USA; Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Most postoperative deaths occur on general wards, often linked to complications associated with untreated changes in vital signs. Monitoring in these units is typically intermittent checks each shift or maximally every 4-6 h, which misses prolonged periods of subtle changes in physiology that can herald a critical downstream event. Continuous monitoring of vital signs is therefore intuitively necessary for patient safety.
View Article and Find Full Text PDFThe role of telemetry monitoring: From diagnosing arrhythmia to predictive models of patient instability.
J Electrocardiol
December 2024
Emory University, Atlanta, GA, USA. Electronic address:
Over the past sixty years, telemetry monitoring has become integral to hospital care, offering critical insights into patient health by tracking key indicators like heart rate, respiratory rate, blood pressure, and oxygen saturation. Its primary application, continuous electrocardiographic (ECG) monitoring, is essential in diverse settings such as emergency departments, step-down units, general wards, and intensive care units for the early detection of cardiac rhythms signaling acute clinical deterioration. Recent advancements in data analytics and machine learning have expanded telemetry's role from observation to prognostication, enabling predictive models that forecast inhospital events indicative of patient instability.
View Article and Find Full Text PDFCall for Decision Support for Electrocardiographic Alarm Administration Among Neonatal Intensive Care Unit Staff: Multicenter, Cross-Sectional Survey.
J Med Internet Res
December 2024
Shanghai Engineering Research Center of Intelligence Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Background: Previous studies have shown that electrocardiographic (ECG) alarms have high sensitivity and low specificity, have underreported adverse events, and may cause neonatal intensive care unit (NICU) staff fatigue or alarm ignoring. Moreover, prolonged noise stimuli in hospitalized neonates can disrupt neonatal development.
Objective: The aim of the study is to conduct a nationwide, multicenter, large-sample cross-sectional survey to identify current practices and investigate the decision-making requirements of health care providers regarding ECG alarms.
Introduction: Frequent and long-term exposure to clinical alarms can cause emergency nurses to lose their trust in alarms, delay their response, and even disable or mute these alarms.
Methods: A cross-sectional study was conducted to assess emergency nurses' knowledge, perceptions, and practices toward clinical alarm fatigue and investigate the perceived obstacles they face when managing clinical alarms.
Results: Less than half of emergency nurses were unfamiliar with the term "alarm fatigue" (40.
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