Ventilated Patient Clinical Surveillance

Ventilated Patient Clinical Surveillance

A Long History in Ventilated Patient Clinical Surveillance

Bernoulli’s roots go back over 25 years to when the company first began to develop and sell mechanical ventilators. Founded by a Yale trained anesthesiologist/intensivist, the company (then Cardiopulmonary Corporation) used advanced networking and connectivity technology to enable remote ventilator monitoring to improve patient care and safety. From that point in time, Bernoulli became a leader in medical device integration (MDI) and developed a central surveillance solution. The integrated solution helps respiratory therapists (RTs) observe all ventilated patients in the hospital from a remote location. What’s more is Bernoulli’s ability to capture real-time data, apply advanced analytics (rules), and display patient status on a remote surveillance dashboard. This helps to better inform clinical decisions.

With vast knowledge of ventilators and vent integration, Bernoulli is the most trusted name in ventilated patient clinical surveillance.

Improving Quality of Care with Ventilated Patient Clinical Surveillance

Caring for Ventilated Patients Across the Health System

Caring for ventilated patients across an entire health system is no easy task. In part because ventilation methods and modes can vary by patient and condition. Because settings and therapy plans may be different for each patient, respiratory therapists (RT) must visit each patient room to review ordered settings and make ventilator adjustments based on the patient’s current state. This is time consuming to say the least. More importantly, if a patient’s condition changes, a timely adjustment to the ventilator may be necessary – but the caregiver may not be at the patient’s bedside. With the advent of non-invasive ventilation and moving of ventilated patients to lower acuity departments in the hospital, RT coverage and patient prioritization have become even more challenging.

The Bernoulli platform includes a central surveillance module that makes caring for ventilated patients across all departments within a health system more efficient. Bernoulli enables remote monitoring for patients on ventilation and empowers the clinician to determine appropriate vent setting adjustments (e.g., respiratory rate, tidal volume, peak inspiratory pressure, and mode) from a central display. More than improving workflows, better care for patients on ventilators can help to improve operational efficiencies such as reduced length of stay and costs.

A Real-Time View of the Patient’s Current State

While the EHR has an important purpose in documenting the patient’s medical journey, the EHR does not provide a real-time view into the patient’s current state. On a busy unit, it may take a nurse many hours to add documentation to the EHR and unfortunately, the patient’s condition may have drastically changed during that time. Understanding the patient’s current state is imperative for making the right treatment plans for the patient.

Because Bernoulli includes a leading MDI capability, the solution integrates with all major brands of ventilators, physiologic monitors, and other patient care devices. More so, Bernoulli captures real-time data from these systems including waveforms and alarms from various types of vents. Analytics applied to real-time data and waveforms can be used to detect deteriorating patient conditions. In some cases, this real-time intel can be used to prevent emergency ventilation, if detected early enough. Furthermore, Bernoulli translates and transfers ventilator data (i.e. real-time vitals) to the EHR so that the EHR becomes more than just a tool for documentation.

Bernoulli also has the ability to integrate with nurse call systems to improve workflow and create a quieter care environment. When a vent alarm is triggered, Bernoulli can light the nurse call dome light outside the patient room which provides a silent visual indication of which patient room is experiencing an alarming condition.

Bernoulli has integrations with many ventilator manufacturers including:

  • Medtronic / Puritan Bennett / Newport
  • Maquet / Siemens
  • Draeger
  • GE Healthcare / VersaMed
  • Hamilton Medical
  • Vyaire / Carefusion / Pulmonetics
  • Philips / Respironics
  • Flight Medical

With Bernoulli’s ventilator integration and real-time data, clinicians have a better picture of the patient’s situation and can make more informed decisions.

Managing Ventilator Alarms and Improving Alarm Safety

Managing ventilator alarms is not a new topic of conversation. In fact, ECRI Institute highlights ventilator alarms in their 2015 and 2017 Top 10 Health IT Hazards reports. More specifically, the 2015 report lists ‘Ventilator Disconnections Not Caught because of Mis-set or Missed Alarms’ as the fifth most hazardous issue and the 2017 report lists ‘Missed Ventilator Alarms Can Lead to Patient Harm’ as the third most hazardous.

With Bernoulli, hospitals can better manage their ventilator alarm conditions, reduce nuisance alarms, quiet patient rooms, and improve outcomes. Continue reading to learn how Bernoulli helped the Hospital for Special Care manage data from over 100 ventilators and reduce vent alarms.

Customer Story:

Ventilated Patient Alarm Surveillance

The Hospital for Special Care (HSC) is the only long term acute care hospital of its kind in New England serving adults and children, and one of only a handful in the country. HSC is nationally recognized for advanced care and rehabilitation in pulmonary care, acquired brain and spinal cord injury, medically-complex adults and pediatrics, neuromuscular disorders, and cardiac diseases.

HSC selected Bernoulli to:

  • Collect and distribute real-time data from over 100 ventilators, as well as pulse oximeters, for enhanced continuous patient surveillance
  • Reduce or eliminate non-actionable alarms while simultaneously providing triage and distribution of relevant alarms, allowing respiratory therapists to focus on patients
  • Analyze objective, comprehensive clinical data after any patient incident to assess response processes and preventative measures

A difficult layout, many ventilators, and a lot of alarms created challenges for clinicians at HSC. These factors also impacted patient experiences. Respiratory therapists spent a lot of time racing from room-to-room responding to hundreds of artifact alarms. In many cases an alarm sounded because a patient coughed or was talking – events that don’t require interventions. However, due to the critical nature of ventilators as life-support devices, these events had to be evaluated.

Bernoulli was first deployed in the 30-bed, 4-team, pediatric unit. This unit had the most complex layout making it difficult for clinicians to move quickly from patient-to-patient. With multiple types of ventilators in use in the unit, a vendor-neutral approach was necessary.

The Bernoulli Solution

Using Bernoulli, real-time data and ventilator alarms were routed to networked laptops, desktop computers, and pagers. With this, clinicians were able to access the condition of the patients in the unit and respond quickly when appropriate. According to the hospital’s Respiratory Practice Manager, Bernoulli One helped reduce the total number of ventilator alarms by approximately 80%. According to Connie Dills, MBA, RRT, RPFT, Respiratory Practice Manager at HSC, “If you go on the units today, it’s very quiet, relative to the number of ventilators in use. Much quieter than it was before we started using Bernoulli.

With the reduction of alarms, HSC has achieved compliance with TJC National Patient Safety Goal for alarm safety. Ms. Dills added, “Alarm management is already a fundamental part of what we do. It’s made a big difference in our staff’s efficiency and effectiveness, and reduced stress for our patients and their families.”

Now with access to more data, HSC is not dependent on individual recollections from the clinical responders after an alarm incident. Ms. Dills said, “A lot of times we didn’t have objective data to access what happened with a patient. Now we can use the data provided by Bernoulli to sort out the story, increasing our accuracy on occurrence reporting and resolution.” Additionally, the data supports future research and benchmarking studies.

Bernoulli One also removed the manual processes associated with ventilator checks. Bernoulli captures all the measured parameters (peak airway pressures, volume, etc.) and settings, eliminating the risk of transcription errors. The automated process also means the RTs spend less time performing menial documentation tasks and more time assessing, treating, and engaging with patients.

Ms. Dill stated, “Bernoulli drastically improves an RT’s efficiency as a patient care coordinator, and improves their responsiveness to specific patient-related issues.”

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