As healthcare evolves and becomes more specialized and as more clinicians become involved in patient cases, patients are more likely to encounter more handoffs than previously experienced. A handoff is defined as the “transfer of information (along with authority and responsibility) during transitions in care across the continuum; to include an opportunity to ask questions, clarify, and confirm”. The World Health Organization (WHO) has identified communication during patient handoffs as a priority concern. Recommendations are in place to ensure smooth handoffs however such transitions are chaotic, unstructured, and extremely stressful. Ineffective handoffs can contribute to gaps in patient care and failures in patient safety including medication errors, wrong-site surgery, and patient mortality. Work from our team has dissected and characterized these errors in a pilot study comprised of three rural fire departments and one critical care transport team. Results showed that the most frequently omitted items which were not mentioned or relayed during the handoff process were the time an incident occurred (90%), identifying the team leader (87.5%), patient pulse oximetry measurements by fire rescue (75%), time of injury till care was received (72.3%), patient weight (70%), introduction of the air crew to the patient (64%), and blood pressure readings obtained by the fire rescue crew (55%). Successful medical transport and patient handovers is highly dependent on the practitioner displaying high mental acuity and situational awareness during stressful moments. Quantitative monitoring of stress can be an opportune and viable platform to assess the actions of the practitioner and correlate peak stress levels with decision-making events and patient outcomes during that time. Wearable sensors present an exciting opportunity to measure human physiological parameters in a real-time and non-intrusive manner by leveraging semiconductor and flexible electronics technology, biomaterials, and related fields. Such an approach would allow for the refinement of protocols which directly address where and when the error is occurring and would enable practitioner-specific training thereby having enormous clinical benefits to decrease errors in patient safety. My preliminary work has led me to conclude that the use of wearable devices to measure and quantify stress levels as a function of various physiological markers (i.e. galvanic skin response, ECG, sweat) and developing or modifying current algorithmic platforms would greatly serve to address this unmet clinical need during high-impact situations [1-2] The proposal is comprised of three parts: 1) assessing the accuracy and efficacy of current wearable devices to quantify stress, 2) configuring a sensor suite based on the results from part 1, and 3) validating the sensor suite. Parts 1 and 3 will involve a clinical study which is adapted and based on a recently approved Institutional Review Board protocol. The goal upon completion of part 3 is to accurately measure stress levels based on physiological markers and quantify the measurement utilizing adapted algorithmic platforms developed in house. We seek the necessary award funds to purchase the sensors to initiate testing to begin this translational research.
Publications pertinent to project:
1. Seshadri DR, Drummond C, Craker J, Rowbottom JR, Voos JE. Wearable Devices for Sports: New Integrated Technologies Allow Coaches, Physicians, and Trainers to Better Understand the Physical Demands of Athletes in Real time. IEEE Pulse. 2017;8(1):38-43. doi:10.1109/MPUL.2016.2627240.
2. Seshadri DR, Rowbottom JR, Drummond C, Voos JE, Craker J. A review of wearable technology: Moving beyond the hype: From need through sensor implementation. In: 2016 8th Cairo International Biomedical Engineering Conference (CIBEC).; 2016:52-55. doi:10.1109/CIBEC.2016.7836118.
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