Avatar-based versus conventional vital sign display in a central monitor for monitoring multiple patients: A multicenter computer-based laboratory study.

Abstract

Background Maintaining adequate situation awareness is crucial for patient safety. Previous studies found that the use of avatar-based monitoring (Visual Patient Technology) improved the perception of vital signs compared to conventional monitoring showing numerical and waveform data; and was further associated with a reduction of perceived workload. In this study, we aimed to evaluate the effectiveness of Visual Patient Technology on perceptive performance and perceived workload when monitoring multiple patients at the same time, such as in central station monitors in intensive care units or operating rooms. Methods A prospective, within-subject, computer-based laboratory study was performed in two tertiary care hospitals in Switzerland in 2018. Thirty-eight physician and nurse anesthetists volunteered for the study. The participants were shown four different central monitor scenarios in sequence, where each scenario displayed two critical and four healthy patients simultaneously for 10 or 30 seconds. After each scenario, participants had to recall the vital signs of the critical patients. Perceived workload was assessed with the National Aeronautics and Space Administration Task-Load-Index (NASA TLX) questionnaire. Results In the 10-second scenarios, the median number of remembered vital signs significantly improved from 7 to 11 using avatar-based versus conventional monitoring with a mean of differences of 4 vital signs, 95% confidence interval (CI) 2 to 6, p < 0.001. At the same time, the median NASA TLX scores were significantly lower for avatar-based monitoring (67 vs. 77) with a mean of differences of 6 points, 95% CI 0.5 to 11, p = 0.034. In the 30-second scenarios, vital sign perception and workload did not differ significantly. Conclusions In central monitor multiple patient monitoring, we found a significant improvement of vital sign perception and reduction of perceived workload using Visual Patient Technology, compared to conventional monitoring. The technology enabled improved assessment of patient status and may, thereby, help to increase situation awareness and enhance patient safety.

Improvements in Patient Monitoring in the Intensive Care Unit: Survey Study

“…As much as the transdisciplinary approach is supported, blunt confidence in user feedback will mainly improve existing devices, as our study prominently indicates, which does not necessarily foster the discovery of disruptive technologies [ 38 ], such as avatar-based patient monitoring [ 39 , 40 ] or smart glasses [ 41 ]. More than cooperation, transdisciplinarity refers to the development of common theories, mutual observation, and search for challenges and needs [ 42 ].…”

Validation of the Raw National Aeronautics and Space Administration Task Load Index (NASA-TLX) Questionnaire to Assess Perceived Workload in Patient Monitoring Tasks: Pooled Analysis Study Using Mixed Models

“…To validate the NASA-TLX, we analyzed data from four different studies all performed by anesthesia and intensive care providers at the University Hospital Zurich and Cantonal Hospital Winterthur in Switzerland, and University Hospital Frankfurt in Germany [ 21 , 23 , 28 , 29 ]. Table 1 provides an overview of the included studies.…”

“…Table 1 provides an overview of the included studies. All of them were investigator-initiated, computer-based, prospective, dual-center studies, and have been published in the past 2 years [ 21 , 23 , 28 , 29 ]. In all studies, we based the recruitment of participants on their clinical availability.…”

“…The Visual Patient central monitoring study [ 29 ] included four different scenarios in which we showed two critical and four healthy patients simultaneously on a central monitor (as in the intensive care unit or operating room) for 10 or 30 seconds. Afterwards, the participants had to recall the patient’s condition.…”

“…The same participants (as in the central monitoring study [ 29 ]) also took part in the Visual Patient distraction study [ 28 ]. In this study, we distracted the participants with standardized simple calculation tasks.…”