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Bernoulli Launches Respiratory Depression Safety Surveillance ( RDSS ) Solution

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Revolutionary New Analytics Application to Address Significant Patient Safety Threat

Milford, CT—April 3, 2017—Bernoulli, the leader in real-time solutions for patient safety, has announced a revolutionary new application for the continuous monitoring of patients at risk of respiratory depression. Bernoulli’s Respiratory Depression Safety Surveillance (RDSS) solution utilizes comprehensive real-time data to help clinicians quickly recognize and respond to signs of respiratory distress. RDSS includes exclusive analytics with multi-variable thresholds—adjustable by the care facility—to identify clinically actionable events while significantly reducing the overall number of alarms communicated to remote and mobile clinicians, mitigating the risk of alarm fatigue.

A Solution to a Growing Patient Safety Threat

More than half of medication-related deaths and 20,000 incidences of respiratory depression-related interventions annually are attributed to the delivery of opioids in a care setting, at a cost of approximately $2 billion per year to the U.S. healthcare system.1

Current monitoring practices are neither adequate nor comprehensive. For example, one of the most common methods—periodic physical spot checks by direct-care clinical staff—can leave patients unmonitored up to 96% of the time.2 Additionally, the adoption of continuous respiratory surveillance is beset by significant challenges, including reduced visual and audible oversight due to single-patient rooms and high nurse-to-patient ratios in many care areas with at-risk patients, and limitations of stand-alone respiratory monitoring devices that can have high rates of false and non-clinically actionable alarms. The disruption of direct-care clinical staff workflow also is a major barrier to continuous monitoring.

Bernoulli’s RDSS solution mitigates many of these clinical, technical and operational challenges. The platform provides connectivity to a hospital’s existing fleet of pulse oximeters and capnographs from a wide range of vendors, including Medtronic, Masimo and others. RDSS also integrates with mobile clinical communication tools to deliver the right alarms and alerts to the right caregiver at the right time.

Proven Clinical Results

In a forthcoming clinical study of patients diagnosed or at risk of obstructive or central sleep apnea, to be published in the Journal of Biomedical Instrumentation & Technology3, the use of Bernoulli’s RDSS analytics reduced 22,812 alarms generated by bedside capnographs and pulse oximeters to just 209 respiratory depression alerts delivered to mobile clinicians—a reduction of 99%. More importantly, the RDSS analytics distributed alerts for every patient that experienced an actual respiratory depression episode.

“The risks inherent in delivering opioids or patient-controlled analgesia to post-operative patients increase the possibility for sentinel events, particularly in patient populations managing chronic illnesses or co-morbidities, such as sleep apnea and obesity,” said Janet Dillione, CEO of Bernoulli. “Bernoulli’s RDSS solution effectively delivers on the recommendations of The Joint Commission, AAMI Foundation and ECRI Institute that hospitals implement continuous respiratory monitoring for these at-risk patients.”

References

  1. Overdyk FJ, Carter R, Maddox RR, Callura J, Herrin AE, Henriquez C. Continuous Oximetry / Capnometry Monitoring Reveals Frequent Desaturation and Bradypnea During Patient-Controlled Analgesia. Anesth Analg. 2007;105:412-8.
  2. Wong M, Mabuyi A, Gonzalez B. First National Survey of Patient-Controlled Analgesia Practices. Physician-Patient Alliance for Health & Safety (PPAHS), October 2013; Web page: premiersafetyinstitute.org/wp-content/uploads/PPAHS-national-survey-patient-controlled-analgesia.pdf.
  3. Supe D, Baron L, Decker T, Parker K, Venella J, Williams S, Beaton K, Zaleski J. A pilot study in middleware-filtered capnography alarms of continuously monitored obstructive sleep apnea patient in a medical-surgical unit. BI&T. May/June 2017. Manuscript in preparation.

 

About Bernoulli

Bernoulli is the leader in real-time solutions for patient safety, with more than 1,200 installed, operational systems. Bernoulli One™ is the market’s only real-time, connected healthcare platform that combines comprehensive and vendor-neutral medical device integration with powerful middleware, clinical surveillance, telemedicine/virtual ICU, advanced alarm management, predictive analytics and robust distribution capabilities into ONE solution that empowers clinicians with tools to drive better patient safety, clinical outcomes, patient experience, and provider workflow. For more information about Bernoulli One™, visit www.bernoullihealth.com. Follow us on Twitter and LinkedIn. Visit our Resource Center to download case studies, white papers and articles.

Bernoulli Launches Respiratory Depression Safety Surveillance Solution

/in , /by

Revolutionary New Analytics Application to Address Significant Patient Safety Threat

Milford, CT—April 3, 2017—Bernoulli, the leader in real-time solutions for patient safety, has announced a revolutionary new application for the continuous monitoring of patients at risk of respiratory depression. Bernoulli’s Respiratory Depression Safety Surveillance (RDSS) solution utilizes comprehensive real-time data to help clinicians quickly recognize and respond to signs of respiratory distress. RDSS includes exclusive analytics with multi-variable thresholds—adjustable by the care facility—to identify clinically actionable events while significantly reducing the overall number of alarms communicated to remote and mobile clinicians, mitigating the risk of alarm fatigue.

A Solution to a Growing Patient Safety Threat

More than half of medication-related deaths and 20,000 incidences of respiratory depression-related interventions annually are attributed to the delivery of opioids in a care setting, at a cost of approximately $2 billion per year to the U.S. healthcare system.1

Current monitoring practices are neither adequate nor comprehensive. For example, one of the most common methods—periodic physical spot checks by direct-care clinical staff—can leave patients unmonitored up to 96% of the time.2 Additionally, the adoption of continuous respiratory surveillance is beset by significant challenges, including reduced visual and audible oversight due to single-patient rooms and high nurse-to-patient ratios in many care areas with at-risk patients, and limitations of stand-alone respiratory monitoring devices that can have high rates of false and non-clinically actionable alarms. The disruption of direct-care clinical staff workflow also is a major barrier to continuous monitoring.

Bernoulli’s RDSS solution mitigates many of these clinical, technical and operational challenges. The platform provides connectivity to a hospital’s existing fleet of pulse oximeters and capnographs from a wide range of vendors, including Medtronic, Masimo and others. RDSS also integrates with mobile clinical communication tools to deliver the right alarms and alerts to the right caregiver at the right time.

Proven Clinical Results

In a forthcoming clinical study of patients diagnosed or at risk of obstructive or central sleep apnea, to be published in the Journal of Biomedical Instrumentation & Technology3, the use of Bernoulli’s RDSS analytics reduced 22,812 alarms generated by bedside capnographs and pulse oximeters to just 209 respiratory depression alerts delivered to mobile clinicians—a reduction of 99%. More importantly, the RDSS analytics distributed alerts for every patient that experienced an actual respiratory depression episode.

“The risks inherent in delivering opioids or patient-controlled analgesia to post-operative patients increase the possibility for sentinel events, particularly in patient populations managing chronic illnesses or co-morbidities, such as sleep apnea and obesity,” said Janet Dillione, CEO of Bernoulli. “Bernoulli’s RDSS solution effectively delivers on the recommendations of The Joint Commission, AAMI Foundation and ECRI Institute that hospitals implement continuous respiratory monitoring for these at-risk patients.”

References

  1. Overdyk FJ, Carter R, Maddox RR, Callura J, Herrin AE, Henriquez C. Continuous Oximetry / Capnometry Monitoring Reveals Frequent Desaturation and Bradypnea During Patient-Controlled Analgesia. Anesth Analg. 2007;105:412-8.
  2. Wong M, Mabuyi A, Gonzalez B. First National Survey of Patient-Controlled Analgesia Practices. Physician-Patient Alliance for Health & Safety (PPAHS), October 2013; Web page: premiersafetyinstitute.org/wp-content/uploads/PPAHS-national-survey-patient-controlled-analgesia.pdf.
  3. Supe D, Baron L, Decker T, Parker K, Venella J, Williams S, Beaton K, Zaleski J. A pilot study in middleware-filtered capnography alarms of continuously monitored obstructive sleep apnea patient in a medical-surgical unit. BI&T. May/June 2017. Manuscript in preparation.

 

About Bernoulli

Bernoulli is the leader in real-time solutions for patient safety, with more than 1,200 installed, operational systems. Bernoulli One is the market’s only real-time, connected healthcare platform that combines comprehensive and vendor-neutral medical device integration with powerful middleware, clinical surveillance, telemedicine/virtual ICU, advanced alarm management, predictive analytics and robust distribution capabilities into ONE solution that empowers clinicians with tools to drive better patient safety, clinical outcomes, patient experience, and provider workflow. For more information about Bernoulli One, visit www.bernoullihealth.com. Follow us on Twitter and LinkedIn. Visit our Resource Center to download case studies, white papers and articles.

ECRI: Top 10 Patient Safety Concerns for Healthcare Organizations

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The ECRI Institute released its latest report, 2017 Top 10 Patient Safety Concerns for Healthcare Organizations. The report’s goal is to help hospitals and health systems decide where to focus patient safety initiatives.

We encourage you to read the the entire ECRI on the Top 10 Patient Safety Concerns, but wanted to highlight a few key areas.

Information Management in EHRs (#1)

“Healthcare organizations must approach health IT safety holistically. …Strategies include ensuring that users understand the system’s capabilities and potential problems [and] encouraging users to report concerns and investigating those concerns.”

Quality and reporting in many hospitals and health systems rely on individual recollections after an incident, which can be inaccurate or incomplete. The appropriate technology can provide healthcare organization with objective data to assess any incident and make measurable, team-focused improvements to the reporting and resolution process.

Patient Safety Resource: Case study—Achieving Clinical Clarity from Ventilator Overload. The Hospital for Special Care was able to achieve real-time surveillance of more than 100 patients on ventilation support. In addition, the hospital was able to use collected data for reporting to its audit committee, which monitors ventilator management performance and identifies potential areas of need.

Unrecognized Patient Deterioration (#2)

“Organizations can develop condition-specific protocols for an organized and speedy response and analyze work systems and processes to identify and address barriers.”

Several alarm techniques and strategies exist for identifying at-risk patients, including smart alarms. These allow for the analysis of the alarm signals themselves, but also the high-fidelity physiological data associated with them, including time trends, in-depth alarm sensitivity and statistical and predictive analysis.

Patient Safety Resource: White paper—Clinical Alarm Management & Reduction: Eliminating alarm proliferation in hospitals and health systems. This white paper outlines the current state of clinical alarm management, demonstrate how to establish a baseline of a hospital’s alarms, and explores innovative alarm reduction strategies to promote more efficient workflow, increase patient safety, and put hospitals on the path toward real-time patient monitoring and intervention.

Implementation and Use of Clinical Decision Support (#3)

“On an ongoing basis, organizations should monitor the effectiveness and appropriateness of CDS alerts, evaluate the impact on workflow, and review staff response to alerts. The tool should be redesigned as necessary.”

The truth is that the overwhelming majority of alarms endured by nurses, respiratory therapists and other caregivers have nothing to do with a patient’s medical condition. However, the fatigue and desensitization that results from caregivers responding to hundreds—or even thousands—of alarms every day is a clear and documented threat to patient safety. Technology can help get alarms under control—but it is not enough. Clinical and IT leadership, including nurses, respiratory therapists, biomedical engineers and information technology staff, must come together to develop the policies and standards necessary to bring meaning and action back to clinical alarms.

Patient Safety Resource: Article—“Why it’s time for an immediate hospital alarm intervention” by Jeanne Venella, DNP, MS, RN, CEN, CPEN, Chief Nursing Officer, Bernoulli. Published May 2016 in DOTMed.

Opioid Administration and Monitoring in Acute Care (#7)

“Organizations may wish to evaluate and address work system and process factors that may contribute to opioid administration errors. For certain patients, capnography or minute ventilation monitoring can supplement nurse monitoring.”

Both patient-managed and staff-administered pain medication are necessary for the patient’s well-being in the hospital. However, their use presents real risk of overdosing and death, especially for patients with complex chronic conditions and co-morbidities. Continuous monitoring can help improve patient safety while keeping the patient comfortable, but careful implementation is necessary to avoid a negative impact on the staff and environment the patient depends on for care.

Patient Safety Resource: Article—“Achieving Real-Time Respiratory Depression Surveillance of Post-Surgical Patients” by Jeanne Venella, DNP, MS, RN, CEN, CPEN, Chief Nursing Officer, and John Zaleski, PhD, CAP, CPHIMS, Executive Vice President and Chief Informatics Officer, Bernoulli. Published Feb. 8, 2017 in PSQH.

Inadequate Organization Systems or Processes to Improve Safety and Quality (#10)

“Proactive strategies can be used to examine processes, identify what can go wrong, and make the process less vulnerable to error before mistakes can occur. Strong preventive strategies, such as standardization and automation, should be explored.”

Technology plays a critical role in patient safety, but it is one piece of a larger solution. Achieving measurable progress in patient safety requires that hospitals identify and support internal champions in all relevant departments including, nurses, respiratory therapists, biomedical engineers, and information technology staff. These interdisciplinary experts must come together to assess the current state of patient safety environment—by unit and facility—including reviewing current protocols; identifying and developing targets for improvement; and evaluating appropriate interventions, policies, and standards. Without the input and expertise from hospital leadership, any patient safety solution will fall short of institutional goals and may put full adoption at risk.

Patient Safety Resource: Webinar—“The Threat of Alarm Fatigue on Patient Safety.”

Final Thoughts

Bernoulli is dedicated to providing clinicians with the technology-enabled capabilities necessary for improving patient safety in real-time. Our commitment to interoperability and vendor-neutral, open architecture both with regards to device connectivity and delivery of data and analytics to other systems of record enables hospitals and health systems to benchmark measureable, sustained improvements to patient safety.

As always, be sure to review our Resource Center to access real-world case studies, white papers, thought leadership and published papers and articles that will help your team make informed decisions about investing in enterprise-wide medical device connectivity, alarm reduction, patient safety analytics—all based on continuous, real-time data.

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