Wireless provides speed, improves care in ICU

Nowhere is the potential for better, faster healthcare offered by wireless devices more welcome than in critical care environments.

As hospital information technology departments start taking advantage of the speed, mobility, and flexibility of handheld wireless computing technologies, caregivers have begun using computer information obtained at bedside to make more accurate and efficient treatment decisions.

Handheld devices are superior to manual data collection and entry for quality improvement projects in medical intensive care units, according to a study presented at CHEST 2001, this week's meeting of the American College of Chest Physicians in Philadelphia.

Researchers found the use of a handheld device simplifies data collection, eliminates manual data entry, and provides prompt availability of information -- on ICU practice patterns, protocol compliance, drug utilization, and ventilator days -- that facilitates process improvement.

"This study demonstrates that use of a handheld device, or PDA (personal data assistant), is a superior alternative to manual data collection and entry in a medical intensive care unit, especially in hospitals that lack sophisticated information systems," said Dr. Barry Fuchs, medical director of the medical ICU at the University of Pennsylvania Medical Center in Philadelphia.

In cases in which data entry requires professional judgment, use of a handheld device or PDA allows the clinician to input data while participating in routine patient-care duties, such as rounds, he said.

"Measuring the effectiveness of quality initiatives for process improvement in critical care units is difficult," Fuchs said.

Typically, this process involves retrospective medical record review and/or hospital database queries unless an electronic medical record or sophisticated ICU information system is available, he said. This approach has several limitations:

• multiple hospital information systems to query

• medical record and nursing flow sheets that are not computerized in most hospitals, meaning patient-specific events cannot be correlated with data from information systems

• data collection not done in real-time and often requiring retrospective chart abstraction

• data often not collected by an ICU practitioner who can interpret clinical findings and make clinical judgments

• analysis of data delayed, obviating potentially time sensitive interventions

According to the Fuchs study, data collection using wireless devices offers several potential improvements:

• Input time for data entry is minimized.

• Time needed for retrospective chart review can be eliminated.

• Need for data reentry is eliminated, reducing the risk of transcription errors.