Study | Design | Sample | Intervention | Control | Results | Distinctive Features |
---|---|---|---|---|---|---|
Starmer et al. (2008) |
Before and after the study |
not clear (presumably the nursing staff) | Ventilator management dashboard, presented as a screensaver and accessible from EMR with indicators for each patient for each patient for each element of ventilator management bundle | none | Increasing compliance with bundle elements (RASS score, weaning, Head of Bed adjustment, OB, oral care). Nurse Managers and Charge Nurses note that dashboard allows them to more quickly see when a nurse is overloaded with patient and can divert resources. |
Each indicator has traffic light status (green done, yellow imminent, red overdue/not done). Indicators are not always up to date as reliant on timely documentation – problematic if workflow uses ‘batch’ Documentation |
Zayfudin et al. (2009) | Interrupted time series analysis Pre-intervention period January 2005-june 2007 (30 Months), implementation in July 222007, post- intervention period August 2007- July 2008 (12 Months) |
Nursing and medical staff |
Ventilator management dashboard, presented as a screensaver with indicators for each patient for each element of ventilator management bundle |
None | Average compliance with ventilator bundle improved from 39% in August 2007 to 89% in July 2008 (P < .001). Rates of ventilator- associated pneumonia(VAP) decreased from a mean(SD) of 15.2(7.0) to 9.3(4.9) events per 1000 ventilator days after introduction of the dashboard (P = .01). Quarterly VAP rates were significantly reduced in the November 2007 through January 2008 and February through April 2008 periods (P < .05). For the August through October 2007 and May through July 2008 quarters, the observed rate reduction was not statistically significant. |
Use of color coding for indicators; green = in compliance, red = out of compliance, yellow = soon due Managers received daily reports on compliance levels |
Debra (2013) |
Before and after the intervention, the implementation of the project was conducted since October 2009. The time interval of before and after is not clear. | Nursing and medical staff |
Ventilator management dashboard, presented as a screen, provided through an electronic health record for each patient as well as the management of pre-defined guidelines relating to the ventilator. | None | In the year prior to the pilot project, the pilot ICU had 3.07 cases of VAP per 1000 ventilator.In the year after the onset of the project, there were 0 cases of VAP |
an individual nurse may take a quick glance at the monitor and see that one of his assigned ventilated patients has a “green” status for periodic wean assessment and therefore does not need immediate attention, but another ventilated patient may show a “red” status for daily oral care, meaning the nurse needs to complete that activity.. |
Heather (2012) | Before and after the intervention. The implementation of the project was conducted since 2007 to 2010. | Nursing and medical staff |
The quality dashboard connected to the medical records of a patient displaying the status of doing the guidelines on the monitor in the ICU. | None | This had led to a 63% reduction in the number of VAP cases over the past 4 years although improving our management of those cases that occur through appropriate antimicrobial therapy based on local microbiology. |
No cases have been mentioned. |