Development of an Interactive Feedback System to Improve Neonatal Resuscitation

开发交互式反馈系统以改善新生儿复苏

• 批准号: 8605763
• 负责人: Tina Anne Leone
• 金额: $ 24万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-11-01 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8605763
• 关键词: Development; Interactive; Feedback; System; Improve

DESCRIPTION (provided by applicant): Approximately 10% of all infants need some form of resuscitation at the time of birth and the interventions performed can have a significant impact on survival.1,2 Resuscitation is a complex process performed by a team of individuals coordinating many different functions. Substantial errors during resuscitations have been documented.3,4,5,6 Errors include lack of recognition of relevant details, and delayed or inconsistent performance of indicated interventions. These errors are frequently related to a lack of relevant situational awareness. This lack of situational awareness is often seen as a team focusing on only one aspect of the resuscitation at the expense of other aspects. We plan to devise a computerized system to be used during resuscitations which will generate prompts intended to focus the team's attention on the entire situation and function as reminders consistent with the resuscitation algorithm. For the most critically ill newborns, a delay or failue to perform a necessary intervention could be life threatening. Delays in achieving normal physiologic adaptation have the potential to contribute to impaired neurologic outcome in survivors. In the first minutes of life normal physiologic parameters, such as oxygen saturation and heart rate, are changing over time, making the identification of indicated interventions more complicated.7,8 The team must integrate the normal physiologic changes with the timeline of the resuscitation. The system that we will develop will display these data in real-time to the resuscitation team. The physiologic data will be used in conjunction with additional user input to generate appropriate voice prompts designed to focus the teams' attention on critical interventions in a timely manner. We intend to make the system upgradeable so that changes to the neonatal resuscitation algorithm can be reflected in the system as they occur. Institutions will be able to use the system to facilitate the performance of resuscitation and will have a simple method of performing their own continuous quality improvement using the data gathered. At the completion of this project we will have developed and tested in a simulation environment a decision support system which will provide appropriate audible and visual prompting during neonatal resuscitation. The system will later be tested in actual human neonatal resuscitations to determine if the use of this system reduces errors, helps maintain situational awareness of the entire team and leader, and most importantly improves resuscitation outcomes by encouraging more timely and relevant interventions. We believe that the use of such a system has the potential to significantly reduce neonatal morbidity and mortality in the most vulnerable and compromised infants.

描述（由申请人提供）：大约有10％的婴儿在出生时需要某种形式的复苏，并且进行的干预措施可能会对生存产生重大影响。1,2复苏是由协调许多不同功能的个体团队执行的复杂过程。复苏期间的实质性错误已记录在第3、4、5、6个错误中，包括缺乏对相关细节的认可，以及指定的干预措施的延迟或不一致的性能。这些错误通常与缺乏相关的情境意识有关。缺乏情境意识通常被视为一个团队，仅关注复苏的一个方面，而牺牲了其他方面。我们计划设计一个计算机化系统，以在复苏期间使用，该系统将产生提示，旨在将团队的注意力集中在整个情况上，并作为与复苏算法一致的提醒。对于最严重的新生儿，进行必要的干预措施可能会威胁生命。实现正常生理适应性的延迟有可能导致幸存者的神经系统效果受损。在生命的第一分钟内，正常的生理参数（例如氧饱和度和心率）随着时间的流逝而变化，使指定干预措施的识别更加复杂。7,8团队必须将正常的生理变化与复苏时间表相结合。我们将开发的系统将实时向复苏团队实时显示这些数据。生理数据将与其他用户输入结合使用，以生成适当的语音提示，旨在及时将团队的注意力集中在关键干预措施上。我们打算使系统可升级，以便可以在系统发生时反映对新生儿复苏算法的更改。机构将能够使用该系统来促进复苏的性能，并使用一种简单的方法来使用收集的数据来执行自己的持续质量改进。该项目完成后，我们将在模拟环境中开发和测试决策支持系统，该系统将在新生儿复苏期间提供适当的听觉和视觉提示。该系统稍后将在实际的人类新生儿复苏中进行测试，以确定使用该系统是否会减少错误，有助于维持整个团队和领导者的情境意识，最重要的是，通过鼓励更及时和相关的干预措施改善复苏结果。我们认为，这种系统的使用有可能显着降低最脆弱和受损的婴儿的新生儿发病率和死亡率。