The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts


Robert N. Leshko1, Kenneth Miller1, Matthew McCambridge1, Angela Lutz1, Kathy Baker1, Diane Horoski1

Introduction: The accurate documentation of vital clinical information is essential when examining patient outcomes. The tracking of patient safety indicators, as the incidence of clinician compliance to reduce the rate of ventilator-associated pneumonia, or the trending the incidence of accidental extubations can be time consuming or less than accurate. With the advent of electronic documentation the ability to recall data is possible with limited chance of error. We examined the rate of accidental extubations and the reporting of the proper documentation of reporting of this patient safety indicator after the implementation of electronic charting.

Methods: Prior to electronic data collection, tracking extubation data was minimal to non-existent. Ventilator days were manually collected, with many variables for error (i.e. missed data due to inconsistent collection - lack of weekend data collection, missed and/or varied qualifying ventilator data, incorrect tracking of ventilator days). Discipline-specific parameters were created to delineate responsibility and continuity of care, which enhanced patient safety. The data must still be entered by the clinician at the bedside, but the use of the electronic charting has now reduced the time for recovery by eighty-percent of the time.

Results: Historically, our failed extubation rate and self-extubated rated varied from 0% to 15% with some months data not collected from all areas of the institution. Results over the last six months since our electronic implementation have shown our self extubation rate to be at an average of 1.55% and our failed extubation rate to be at 5.4%. Paper charting results lacked a consistent and reliable method of collection. The retrieval of this data now comes in the form of a quicker and more efficient process.

Conclusion: The use of electronic charting has now given us another tool to use in the quality of care we provide for our patients. As we continue to move forward we have made the stepping stones for the use of electronic charting in quality patient care. It clearly demonstrated the need to formulate collaborative, uniform data collection, with attention to protocol and defined outcome goals throughout the entire organization.