An exploratory clinical evaluation of a head-worn display based multiple-patient monitoring application: impact on supervising anesthesiologists’ situation awareness

Abstract

Purpose

Supervising anesthesiologists overseeing several operating rooms must be aware of the status of multiple patients, so they can consult with the anesthetist in single operating rooms or respond quickly to critical events. However, maintaining good situation awareness can be challenging when away from patient bedsides or a central monitoring station. In this proof-of-concept study, we evaluated the potential of a head-worn display that showed multiple patients’ vital signs and alarms to improve supervising anesthesiologists’ situation awareness.

Methods

Eight supervising anesthesiologists each monitored the vital signs of patients in six operating rooms for 3 h with the head-worn display, and for another 3 h without the head-worn display. In interviews with each anesthesiologist, we assessed in which situations the head-worn display was used and whether the continuous availability of the vital signs improved situation awareness. We also measured situation awareness quantitatively from six of the eight anesthesiologists, by instructing them to press a button whenever they noticed a patient alarm.

Results

The median number of patient alarms occurring was similar when the anesthesiologists monitored with the head-worn display (42.0) and without the head-worn display (40.5). However, the anesthesiologists noticed significantly more patient alarms with the head-worn display (66.7%) than without (7.1%), P = 0.028, and they reported improved situation awareness with the head-worn display. The head-worn display helped the anesthesiologists to perceive and comprehend patients’ current status and to anticipate future developments. A negative effect of the head-worn display was its tendency to distract during demanding procedures.

Conclusions

Head-worn displays can improve supervising anesthesiologists’ situation awareness in multiple-patient monitoring situations. The anesthesiologists who participated in the study expressed enthusiasm about monitoring patients with a head-worn display and wished to use and evaluate it further.

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Acknowledgements

The authors thank Dr. Michael Neumann, Dr. Frank Kobelt, and the other members of the SMI team of the University Hospital of Würzburg who helped to integrate the HWD into the hospital’s IT systems for their great support.

Funding

The authors declare that they have not received any funding for their research.

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Correspondence to Paul D. Schlosser.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The hospital’s ethics committee was informed about the study and on 13 December 2017 we received a waiver that no ethics clearance was required.

Informed consent

was obtained from all individual participants included in the study.

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Schlosser, P.D., Grundgeiger, T., Sanderson, P.M. et al. An exploratory clinical evaluation of a head-worn display based multiple-patient monitoring application: impact on supervising anesthesiologists’ situation awareness. J Clin Monit Comput 33, 1119–1127 (2019). https://doi.org/10.1007/s10877-019-00265-4

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Keywords

  • Patient monitoring
  • Remote monitoring
  • Head-worn display
  • Situation awareness