Improving Task-Severity Awareness in Intensive Care Units

Abstract

Intensive Care Units (ICUs) are complex socio-technical systems where interruptions can lead to medical errors. However, not all interruptions have a negative impact on patient safety. Most interruption mitigation strategies are reductionist in approach and may remove potentially important task- or patient-related information from the environment. In addition, mitigation techniques rarely involve technological interventions. In an effort to address this issue, a system called the Task-Severity Awareness Tool (TAT) was developed to make the severity of task-at-hand visible by enabling nurses to interact with several buttons during high-severity tasks to activate an awareness display (displaying “Do Not Disturb”) that was located outside the ICU room. The TAT was effective at mitigating interruptions in the ICU environment, but it had several limitations including fixed actuators (i.e., buttons and foot pedals) and poor visibility (the LED display was located above the ICU door frame and could be easily missed). The objective of this research was to address the limitations of TAT and evaluate a novel Wireless Task-Severity Awareness Tool (WTAT). WTAT used wireless actuation using a smartwatch application and used an LED strip wrapped around the door frame to improve visibility. A study with 30 college students was carried out using the Tobii Pro Glasses 2 eye-tracker to evaluate the visibility of the WTAT compared to TAT. The results show that WTAT attracted a significantly larger number of fixations and visits. The findings of this study provide evidence for the efficacy of using LED strips for awareness displays to improve visibility. Future work is needed to evaluate if such improved visibility can help reduce unnecessary interruptions in the ICU.