Heart Rate Variability for Practitioner Stimulated Reflection and Decision-making Optimisation

Обзор

At the heart of healthcare is the interaction between healthcare practitioners and patients. It is believed that optimisation of this interaction can improve patient relevant outcomes, safety and patient experience. Through utilisation of practitioner physiological data, heart rate variability (HRV), to help practitioners make better decisions and optimise practice, it is considered possible to improve decision making around patient care and improve outcomes and safety. The modern intensive care unit (ICU) is a dynamic data rich environment requiring rapid and accurate decision making. Advances in ventilator technology, electronic patient monitoring and electronic health records (EHR) have provided exponential growth in data produced for patients and the need for complex decision making. However, data overload and alarm fatigue can result in poor understanding and a delayed response from the practitioner in addressing the patient's needs. The aim of this study is to present and evaluate a psychophysiology training approach for practitioners derived from their cardiovascular response through the course of the working day, this will be measured using heart rate variability (HRV). Practitioner HRV has been shown to be linked to work related stress and is considered a biomarker of decision-making.

Подробное описание

A Critical Participatory Action Research learning model is proposed, whereby practitioners can explore the nature and consequences of their practice utilising their HRV during two intervention periods. The aim is to improve practitioner performance and develop a more context aware approach to patient care.

Impact will be measured through:

* improvement in HRV of the practitioners * measurement of response times to ventilator related events (decreased response times) * improvement of time spent at bedside * improvement in ventilation related outcomes for the patients. * Reduction in bedside noise (reduced response time to alarms and reduction in inappropriate alarms)

Вмешательства

• Поведенческое Critical Participatory Action Intervention with HRV Feedback
  The intervention is based on a Critical Participatory Action Research learning model, using the participant's heart rate variability data collected during clinical shifts. Before the intervention, participants will complete repeated HRV monitoring and use a diary to record clinical events and reflections. The intervention includes facilitated workshops introducing reflective practice, cognitive bandwidth, and related educational concepts. Participants will receive individual coaching to review t

Первичные конечные точки

• Reduction in response time to ventilator patient physiological alarms [Срок оценки: At completion of 20th clinical shift (each shift is 12 hours)]
• Adherence to bedside noise level targets [Срок оценки: At completion of 20th clinical shift (each shift is 12 hours)]

Вторичные конечные точки (2)

• Improvement in practitioner heart rate variability during clinical practice [Срок оценки: At completion of 20th clinical shift (each shift is 12 hours)]
• Participant-reported work effectiveness, job satisfaction, and stress levels [Срок оценки: At completion of 20th clinical shift (each shift is 12 hours)]

Критерии участия

Критерии включения

• Nurse working in Enhanced Recovery Unit at Royal Papworth Hospital NHS Foundation Trust
• Willingness to participate in the trial

Критерии исключения

• Staff with permanent pacemakers
• Staff on medication that could affect HRV (e.g. b-blockers)

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Не применимо

Модель

Одна группа

Маскирование

Открытое

Основная цель

Организация здравоохранения

Центры проведения

Великобритания · 1 центр

• Royal Papworth Hospital NHS Foundation Trust — Cambridge

Идентификаторы

NCT: NCT07709364 · P03174 · 25/HRA/2201

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

Открыть это исследование на ClinicalTrials.gov ↗