ArticleCritical care explorations2019
Clinical Impact of an Electronic Dashboard and Alert System for Sedation Minimization and Ventilator Liberation: A Before-After Study.
Article in Critical care explorations, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- AARC Clinical Practice Guideline: Spontaneous Breathing Trials for Liberation From Adult Mechanical Ventilation.Respiratory care · 2024Guideline
- Implementation of coordinated spontaneous awakening and breathing trials using telehealth-enabled, real-time audit and feedback for clinician adherence (TEACH): a type II hybrid effectiveness-implementation cluster-randomized trial.Implementation science : IS · 2023Trial
- Article
- Clinical and economic impact of digital dashboards on hospital inpatient care: a systematic review.JAMIA open · 2025Review
- Development, Implementation, and Evaluation Methods for Dashboards in Health Care: Scoping Review.JMIR medical informatics · 2024Article
- Investigating Why Clinicians Deviate from Standards of Care: Liberating Patients from Mechanical Ventilation in the ICU.Proceedings of the SIGCHI conference on human factors in computing systems. CHI Conference · 2024Article
- Improving Outcomes in Mechanically Ventilated Adult ICU Patients Following Implementation of the ICU Liberation (ABCDEF) Bundle Across a Large Healthcare System.Critical care explorations · 2024Article
- Effect of an electronic medical record nudge to improve quality improvement program tracking of neuraxial catheter replacements in obstetric patients.BMJ open quality · 2023Article
- Awakening and Breathing Coordination: A Mixed-Methods Analysis of Determinants of Implementation.Annals of the American Thoracic Society · 2023Article
- Supporting Decision-Making About Patient Mobility in the Intensive Care Unit Nurse Work Environment: Work Domain Analysis.JMIR nursing · 2022Article
- The Rapid Implementation of Ad Hoc Tele-Critical Care Respiratory Therapy (eRT) Service in the Wake of the COVID-19 Surge.Journal of clinical medicine · 2022Article
- Nudging healthcare professionals to improve treatment of COVID-19: a narrative review.BMJ open quality · 2021Review
- Promoting Evidence-Based Practice in Acute Respiratory Distress Syndrome: A Systematic Review.Critical care explorations · 2021Review
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
Sedation minimization and ventilator liberation protocols improve outcomes but are challenging to implement. We sought to demonstrate proof-of-concept and impact of an electronic application promoting sedation minimization and ventilator liberation.
designMulti-ICU proof-of-concept study and a single ICU before-after study.
settingUniversity hospital ICUs. PATIENTS: Adult patients receiving mechanical ventilation.
interventionsAn automated application consisting of 1) a web-based dashboard with real-time data on spontaneous breathing trial readiness, sedation depth, sedative infusions, and nudges to wean sedation and ventilatory support and 2) text-message alerts once patients met criteria for a spontaneous breathing trial and spontaneous awakening trial. Pre-intervention, sedation minimization, and ventilator liberation were reviewed daily during a multidisciplinary huddle. Post-intervention, the dashboard was used during the multidisciplinary huddle, throughout the day by respiratory therapists, and text alerts were sent to bedside providers. MEASUREMENTS AND MAIN
resultsWe enrolled 115 subjects in the proof-of-concept study. Spontaneous breathing trial alerts were accurate (98.3%), usually sent while patients were receiving mandatory ventilation (88.5%), and 61.9% of patients received concurrent spontaneous awakening trial alerts. We enrolled 457 subjects in the before-after study, 221 pre-intervention and 236 post-intervention. After implementation, patients were 28% more likely to be extubated (hazard ratio, 1.28; 95% CI, 1.01-1.63;
conclusionsImplementation of an electronic dashboard and alert system promoting sedation minimization and ventilator liberation was associated with reductions in the duration of mechanical ventilation and ICU length of stay.
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Registered trials
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