The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts


Kenneth Miller, Diane Horoski, Robert Leshko, Micheal Weiss, Angela Lutz; Respiratory Care, LVHN, Allentown, PA

Introduction: Health information technology is being increasingly used in the intensive care unit population to improve patient outcomes and monitor staff performance. Methods: We implemented an intensive care unit electronic medical record (ICU EMR) that would serve both as a bedside medical record and database. Data was self-populated electronically from the mechanical ventilators and manually entered by the bedside respiratory therapist. A Clinical Information System Specialist (CISS) supervised the implementation and data entry. Clinical Information System Specialist was a respiratory therapist with extensive clinical background. Data could be queried in real time and on an ongoing basis. Results: Patients were enrolled over an 18-month period, from January 1st, 2008 to June 30th, 2009. There were a total of 4569 episodes in which a patient required mechanical ventilation. Of the 4569 episodes, 4020 (88.0%) had respiratory therapist entered outcomes data whereas no outcome data was entered for the remaining 549 (12.0%) episodes. Of the 4020 mechanical ventilation episodes with outcomes data, 3296 episodes (82.0%) were extubated successfully without a need for reintubation. The mechanical ventilator was withdrawn as part of the palliative care process in 392 episodes (9.8%). One-hundred twenty-nine mechanical ventilation episodes (3.2%) resulted in death while the patient was receiving mechanical ventilation. Eighty-eight patients (2.2%) were transferred to long-term care facilities while being ventilated and twelve patients (0.3%) were sent home on a ventilator. There were 102 self-extubations episodes (2.5%) of which eighteen (17.6%) required reintubation. Of the 4020 episodes of mechanical ventilation, 162 (4.0%) required re-intubation within 24 hours and 146 (3.6%) required re-intubated after 24 hours. Conclusion: We implemented an ICU EMR that accepts data both electronically and manually from our respiratory therapy providers. The ICU EMR serving both as a bedside medical record and database will allow us to easily monitor our mechanical ventilation outcomes on an ongoing basis and monitor staffÂ’s clinical documentation. Sponsored Research - None