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Abstract BackgroundMillions of catheters for invasive arterial pressure monitoring are placed annually in intensive care units, emergency rooms, and operating rooms to guide medical treatment decision-making. Accurate assessment of arterial blood pressure requires an IV pole-attached pressure transducer placed at the same height as a reference point on the patient’s body, typically, the heart. Every time a patient moves, or the bed is adjusted, a nurse or physician must adjust the height of the pressure transducer. There are no alarms to indicate a discrepancy between the patient and transducer height, leading to inaccurate blood pressure measurements. MethodsWe present a low-power wireless wearable tracking device that uses inaudible acoustic signals emitted from a speaker array to automatically compute height changes and correct the mean arterial blood pressure. Performance of this device was tested in 26 patients with arterial lines in place. ResultsOur system calculates the mean arterial pressure with a bias of 0.19, inter-class correlation coefficients of 0.959 and a median difference of 1.6 mmHg when compared to clinical invasive arterial measurements. ConclusionsGiven the increased workload demands on nurses and physicians, our proof-of concept technology may improve accuracy of pressure measurements and reduce the task burden for medical staff by automating a task that previously required manual manipulation and close patient surveillance.
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This content will become publicly available on June 1, 2025
Applying ordered network analysis to video-recorded physician–nurse interactions to examine communication patterns associated with shared understanding in inpatient oncology care settings
ObjectivesThe main aim of this study was to demonstrate how ordered network analysis of video-recorded interactions combined with verbal response mode (VRM) coding (eg, edification, disclosure, reflection and interpretation) can uncover specific communication patterns that contribute to the development of shared understanding between physicians and nurses. The major hypothesis was that dyads that reached shared understanding would exhibit different sequential relationships between VRM codes compared with dyads that did not reach shared understanding. DesignObservational study design with the secondary analysis of video-recorded interactions. SettingThe study was conducted on two oncology units at a large Midwestern academic health care system in the USA. ParticipantsA total of 33 unique physician–nurse dyadic interactions were included in the analysis. Participants were the physicians and nurses involved in these interactions during patient care rounds. Primary and secondary outcome measuresThe primary outcome measure was the development of shared understanding between physicians and nurses, as determined by prior qualitative analysis. Secondary measures included the frequencies, orders and co-occurrences of VRM codes in the interactions. ResultsA Mann-Whitney U test showed that dyads that reached shared understanding (N=6) were statistically significantly different (U=148, p=0.00, r=0.93) from dyads that did not reach shared understanding (N=25) in terms of the sequential relationships between edification and disclosure, edification and advisement, as well as edification and questioning. Dyads that reached shared understanding engaged in more edification followed by disclosure, suggesting the importance of this communication pattern for reaching shared understanding. ConclusionsThis novel methodology demonstrates a robust approach to inform interventions that enhance physician–nurse communication. Further research could explore applying this approach in other healthcare settings and contexts.
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- Award ID(s):
- 2225240
- PAR ID:
- 10540978
- Publisher / Repository:
- BMJ Open
- Date Published:
- Journal Name:
- BMJ Open
- Volume:
- 14
- Issue:
- 6
- ISSN:
- 2044-6055
- Page Range / eLocation ID:
- e084653
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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