DeviceUse Study

Project Name

DeviseUse Study (this is the spelling of the study in our program and on the wiki)

Purpose

Patient quality of care improvements in Critical Care.

• Monitor resource allocation and monitor complication rates related to length of ICU medical device use. (VAP, Central Line Related Blood stream Infection (CLR-BSI), unplanned extubations)

Who

Information to be collected from charts daily by Regional Database Team - Critical Care areas.

• Monitoring being done by the Critical Care QI Team along with the cross Canada ICU collaborative project teams CCVSM. Members of the CCQI team will also provide ongoing support and feedback for issue related to collection of this data from chart.
• Laura Kolesar will be the lead data collector who will work with CCQI team, Statistician & Tina Tenbergen on matters related to this project.

Where

Collected in L_Tmp

• Deposited into data repository L TmpV2 in the output folder on the Regional Server.

How often data is sent

• Information sent each week with sending to L TmpV2 even though patient files is not complete.

Template:Discussion Because the DeviceUse data will be repeatedly send each week to L_TMPV2, the collectors must be precise when entering any dates and time for devices and not be putting dummy times in and keep changing them. The statistician will be reporting this information weekly regardless if the rest of file is completed or not. Will need to discuss this more later.

• • Is anyone else going to have a hard time getting precise times when entering the dates? I think this will be a challenge! GHall 20:26, 6 September 2011 (CDT)
    • I wonder if the focus is on actual times rather than dummy ones; considering the paragraph then explains that the data will be sent every time, I would think that that is what this is about more than accuracy. Ttenbergen 09:38, 7 September 2011 (CDT)
      • We will pilot the process first and find out what the issue might be in obtaining this data and work them out before we actually launch. The only way we will know if there will be issues dates and in particular, times, is when we actually test the process first and find out.--TOstryzniuk 17:52, 7 September 2011 (CDT)
        • I think precise times will be hard to find. How precise do you want to be? This will definatly take some extra time to collect. Lois

Items Collected

S_Tmp:

• Art line_IN - date & time
• Art line_OUT - date & time

• 1st Central line_IN - date & time
• Last-Central line_OUT
  • NOTE: It doesn't matter how many central lines a patient has each day. One patient with three central lines, line count is "one" line for that patient for that day.

• PICC line _IN - date & time
• PICC line_OUT - date & time

• ETT_IN - date & time
• ETT_OUT - date & time - (bool_var) unplanned extubation check mark means YES
  • uplanned extubation is defined as unscheduled removal of an endotraacheal tube (excludes tracheostomy tube) either related to the accidental dislodgement due to care processes or due to patient extubating self.

• Trach_IN - date & time
• Trach_OUT - date & time

• Vent start_IN - date & time
• Vent stop_OUT - date & time
  • DC Vent will be defined as OFF the ventilator for >=48 hrs

• BIPAP/CPAP start_IN - date & time
• BIPAP/CPAP stop_OUT - date & time
  • DC BIPAP will be defined as OFF the ventilator for >=24 hrs

Instructions for collecting

• • • For each option you need to click on "edit" to bring up the full page, on this page you will see a box to tick off if the "in" item (device) is present on admission. For the "out" item the option to tick will say "present on discharge".
    • The focus is to determine number of days with each device but if the device is present on admission it is not necessary to try to find prior date and time for this. If the device is removed or stopped for a few days and then a new device is used, this new date and time needs to be documented, ensuring that the original date and time of removal or stop is indicated.
    • A separate item is unplanned extubations. Even when this occurs, be sure to also indicate ETT out date and time even if it is the same as the unplanned. This is necessary because the pt may be re-intubated and then the ETT out will not be completed at the same date and time because the ETT days will continue.
    • Home bipap or cpap is included in this study.

Further instructions will follow as we start working with this tool. Anyone can start trialing this any time because Tina has put it on the laptops. This only applies to critical care collectors. Feedback is welcomed as you start collecting this information. The actual project will start Jan 1, 2011 but you are encouraged to work with it on a trial basis somewhat before that date so that you are familiar with it and all the glitches can be worked out.

Start Date

Anyone who wishes to test this is welcome to do so. Start of testing Oct 1.11. Document any difficulties encountered. The actual start date of the project will be Jan 1, 2011. Be sure to at least try this out prior to the start date to ensure familiarity.

Analysis

Will be handled by Statistician

1. number of central line days between Central Line Related Blood stream Infection (CLR-BSI)
2. number of Vent days between unplanned extubations
3. number of Vent days between VAP

--TOstryzniuk 18:02, 31 August 2011 (CDT)