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A computerized alert system for hypokalemia can decrease time to treatment
Critical Care volume 9, Article number: P410 (2005)
Computerized systems are becoming increasingly important in critical care. Systems can record physiological data automatically, leading to improved charting and reducing time requirement for charting by nurses , and can perhaps impact favorably on clinical decisions.
An additional potential advantage of computerized systems is the ability to alert clinicians to various clinical occurrences, thus improving care. This has been shown regarding hypokalemia in a hospital-wide computerized system . We examined the impact of a computerized alert for a low potassium level in our general ICU. We hypothesized that an alert provided by the computerized system will reduce the response time of the clinical staff to hypokalemia.
The general ICU at the Sheba Medical Center is a 12-bed ICU in a 1600-bed tertiary hospital. Three years ago a computerized system was implemented (Metavision; IMDsoft Ltd, Israel). The system receives and charts data automatically. The system has an 'Event Manager' module that enables clinicians to determine various indicators that will trigger an alert to the staff. We created an alert that responds to a low potassium level by presenting a message at the patient workstation indicating that a low potassium measurement has been detected and consideration should be given for supplemental potassium. The clinical staff received a general update regarding the implementation of the event without specific training. The event was introduced almost 2 years after the staff had been working with the computerized system. We retrospectively looked at the time to treat (TTT) from measurement of a potassium level lower than 2.9 meq/l during the year before the event was implemented (Before event) and compared this with the time period after the event was implemented (After event). There was a statistically significant reduction in the time to treat between the two time periods (Table 1).
A computerized alert that notifies clinicians of a low potassium measurement can decrease the time to recognition and treatment of hypokalemia, and thus improve care.
Computerized alerts regarding laboratory results may impact clinical care.
Bosman RJ, Rood E, Oudemans-van Straaten HM, et al.: Intensive care information system reduces documentation time of the nurses after cardiothoracic surgery. Intensive Care Med 2003, 29: 83-90.
Paltiel O, Gordon L, Berg D, et al.: Effect of a computerized alert on the management of hypokalemia in hospitalized patients. Arch Intern Med 2003, 163: 200-204. 10.1001/archinte.163.2.200
ES and AP are consultants to IMDsoft.
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Segal, E., Toderis, L., Livingstone, D. et al. A computerized alert system for hypokalemia can decrease time to treatment. Crit Care 9, P410 (2005). https://doi.org/10.1186/cc3473
- Clinical Staff
- Potassium Level
- Computerize System
- Tertiary Hospital