DeviceUse Study

Project Name

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

Purpose

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) to improve patient quality of patient care in critical care.

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

Data will be collected in all ICUs in the region.

Data will be stored de-identified in 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.

discussion re. getting exact times

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

Instructions for collecting

• The focus is to determine number of days with each device while in the unit
• For each of the following devices, enter an in and out record for each device present:
  • devices:
    • Art line
    • Central line (first in and last out)
      • doesn't matter how many central lines a patient has at the same time
    • PICC line
    • ETT
    • Trach
    • Vent
      • Out will be defined as OFF the ventilator for >=48 hrs
    • BIPAP/CPAP
      • DC BIPAP will be defined as OFF the ventilator for >=24 hrs
      • Home bipap or cpap is included in this study.
  • on "in" record, tick off "present on admission" instead of entering a date if the device is present on admission
  • on "out" record, tick off "present on discharge" instead of entering a date if the device is present on discharge
• If the device is removed or stopped for a few days and then a new device is used, a new set of entries is required to get an accurate duration for the device.
• If an unplanned extubation occurs enter a record for this in addition to documenting the ETT in and out records
  • if patient is re-intubated then the ETT out will not be completed at the same date and time because the ETT days will continue.
  • Template:Discussion I think this will need to be clarified with Julie to get it right...Ttenbergen 14:07, 6 October 2011 (CDT)

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

Testing

Anyone who wishes to test this is welcome to do so. Start of testing Oct 1.11. Document any difficulties encountered. Be sure to at least try this out prior to the start date to ensure familiarity.

Data collection

The actual start date of the project will be Jan 1, 2011.

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)