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Titre du Document
Poor prognosis for existing monitors in the intensive care unit
Auteur(s)
TSIEN C. L. ; FACKLER J. C.
Résumé
Objective: To identify areas requiring the most urgent improvement in the intensive care unit (ICU); and to accurately determine the positive predictive value of routine critical care patient monitoring alarms, as well as the common causes for false-positive alarms. Design: Prospective, observational study. Setting: A multidisciplinary ICU in a university-affiliated children's hospital (excluding children with primary heart disease). Interventions: The occurrence rate, cause, and appropriateness of all alarms from tracked monitors were recorded by a trained observer and validated by the bedside nurse over a 10-wk period for a single bedspace at a time. Measurements and Main Results: After 298 monitored hrs, 86% of a total 2,942 alarms were found to be false-positive alarms, while an additional 6% were classified as clinically irrelevant true alarms. Only 8% of all alarms tracked during the study period were determined to be true alarms with clinical significance. Alarms were also classified according to whether they were clearly associated with a patient intervention (18%), were clearly not associated with a patient intervention (74%), or had unclear association to interventions (8%). While 11% of nonpatient intervention alarms were clinically significant true alarms, only 2% of patient intervention alarms were so. Positive predictive values for the various devices ranged from <1% for the pulse oximeter's heart rate signal to 74% for the arterial catheter's mean systemic bloo
Editeur
Lippincott
Identifiant
PMID : 9142025 ISSN : 0090-3493 CODEN : CCMDC7
Source
Critical care medicine A. 1997, vol. 25, n° 4, pp. 614-619 [bibl. : 21 ref.]
Langue
Anglais
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