Telemedicine Versus Face-to-Face Evaluations by Respiratory Therapists of Mechanically Ventilated Neonates and Children: A Pilot Study.
نویسندگان
چکیده
BACKGROUND Mechanical ventilation is one of the most important therapeutic interventions in neonatal and pediatric ICUs. Telemedicine has been shown to reliably extend pediatric intensivist expertise to facilities where expertise is limited. If reliable, telemedicine may extend the reach of pediatric respiratory therapists (RTs) to facilities where expertise does not exist or free up existing RT resources for important face-to-face activities in facilities where expertise is limited. The aim of this study was to determine how well respiratory assessments for ventilated neonates and children correlated when performed simultaneously by 2 RTs face-to-face and via telemedicine. METHODS We conducted a pilot study including 40 assessments by 16 RTs on 11 subjects (5 neonatal ICU; 6 pediatric ICU). Anonymously completed intake forms by 2 different RTs concurrently assessing 14 ventilator-derived and patient-based respiratory variables were used to determine correlations. RESULTS Forty paired assessments were performed. Median telemedicine assessment time was 8 min. The Pearson correlation coefficient (r) was used to determine agreement between continuous data, and the Cohen kappa statistics were used for binary variables. Pressure control, PEEP, breathing frequency, and FIO2 perfectly correlated (r = 1, all P < .001) as did the presence of a CO2 monitor and need for increased ventilatory support (kappa = 1). The Pearson correlation coefficient for VT, minute ventilation, mean airway pressure, and oxygen saturation ranged from 0.84 to 0.97 (all P < .001). kappa = 0.41 (95% CI 0.02-0.80) for patient-triggered breaths, and kappa = 0.57 (95% CI 0.19-0.94) for breathing frequency higher than set frequency. kappa = -0.25 (95% CI -0.46 to -0.04) for need for suctioning. CONCLUSIONS Telemedicine technology was acceptable to RTs. Telemedicine evaluations highly correlated with face-to-face for 10 of 14 aspects of standard bedside respiratory assessment. Poor correlation was noted for more complex, patient-generated parameters, highlighting the importance of further investigation incorporating a virtual stethoscope.
منابع مشابه
Evaluating the Short-Term Outcome of Mechanically Ventilated Neonates Admitted to the Neonatal Intensive Care Unit of Besat Hospital, Hamadan, Iran
Background Many neonates admitted to Neonatal Intensive Care Unit (NICU) need mechanical ventilation for recovery. This study was designed to evaluate the short-term outcome of mechanically ventilated neonates admitted to NICU. <span style="fon...
متن کاملSatisfaction with telemedicine for teaching listening and spoken language to children with hearing loss.
Auditory-Verbal Therapy (AVT) is an effective early intervention for children with hearing loss. The Hear and Say Centre in Brisbane offers AVT sessions to families soon after diagnosis, and about 20% of the families in Queensland participate via PC-based videoconferencing (Skype). Parent and therapist satisfaction with the telemedicine sessions was examined by questionnaire. All families had b...
متن کاملطراحی ابزار روا و پایا جهت ارزیابی صلاحیت بالینی کاردرمانگران
Objective: The aim of study was to design a valid and reliable tool for assessing the occupational therapists’ clinical competency. Materials & Methods: It was a tool-making study. Many clinical competency statements were extracted from evidences and with two expert-panels helped to emerge a questionnaire with sixty-six statements in seven categories. Face and content validity were confirmed...
متن کاملEvaluation of the Effect of Nebulized N-Acetylcysteine on Respiratory Secretions in Mechanically Ventilated Patients: Randomized Clinical Trial
Background: The purpose of our study was to evaluate an inexpensive and available method to reduce mucous impactions in mechanically ventilated patients.Methods: This randomized clinical trial was conducted on 40 mechanically ventilated patients aged 15-90 years. The patients were randomly allocated into two arms; 20 cases and 20 controls. The cases received N-acetylcysteine via their nebulizer...
متن کاملTherapeutic factors affecting the cognitive behavioral treatment of bulimia nervosa via telemedicine versus face-to-face delivery.
OBJECTIVE Recently, Mitchell et al. (Behav Res Ther, 46, 581-592, 2008) conducted a randomized controlled trial of an empirically supported treatment for bulimia nervosa (BN) delivered face-to-face (FTF-CBT) or via telemedicine (TV-CBT). Results suggested that the TV-CBT and FTF-CBT were generally equivalent in effectiveness. The objective of the current study was to examine ratings of therapeu...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Respiratory care
دوره 61 2 شماره
صفحات -
تاریخ انتشار 2016