DATA QUALITY OF BEDSIDE MONITORING IN AN INTENSIVE-CARE UNIT

Computerized record keeping promises complete, accurate and legible do cumentation. Reliable measurements are a prerequisite to fulfill these expectations. We analyzed the physiological variables provided by bed side monitoring devices in 657 bedside visits performed by an experien ced Intensive Care nurse during 75 Intensive Care rounds. We registere d which variables were displayed. If a variable was displayed, we asse ssed whether it could be used for documentation or should be rejected. If a value was rejected the reason was registered as: the measurement was not intended (superfluous display), the current clinical situatio n did not allow proper measurement, or other reasons. Basic variables (vital signs and respiration related variables) were displayed in more then 90%, specific variables (e.g. intracranial pressure) were displa yed in less than 50% of the situations. Displayed variables were super fluous on an average of 11% because measurement was not intended. Vari ables like heart rate, temperature, airway pressure, minute volume of ventilation, arrhythmia, pulmonary arterial pressure, non-invasive blo od pressure, and intracranial pressure provide high quality measured v alues (acceptance of more than 90%). Invasive arterial pressure, centr al venous pressure, respiration rate and oxygen saturation (via pulse oximetry) provided lower quality values with a rejection rate higher t han 10%. Inappropriate sensor technology to match the clinical environ ment seems to be the root cause. In future the request for automatic d ocumentation will increase. In order to avoid additional staff workloa d and to ensure reliable documentation, sensor technology especially r elated to respiration rate, blood pressure measurements, and pulse oxi metry should be improved.