For Release: March 5, 2010
David Corriveau, Media Relations Officer, Dartmouth Medical School, at David.A.Corriveau@Dartmouth.edu or 603-653-0771
Closer watch, fewer ICU trips, Dartmouth anesthesiologists find
Hanover, N.H.—Thanks to systematic monitoring of patients after surgery, Dartmouth anesthesiologists are reporting a dramatic drop in rescue calls and transfers to intensive-care units.
Andreas H. Taenzer, M.D., and his colleagues published results from their system of surveillance tracking in the February 2010 issue of Anesthesiology. After collecting data for nearly two years, Taenzer's team observed that emergency rescue calls dropped from 3.4 to 1.2 per 1,000 patient discharges, and intensive care unit (ICU) transfers declined from 5.6 to 2.9 per 1,000 patient days.
"Our primary finding is that early detection of patient deterioration in important areas such as oxygen saturation and heart rate led to fewer rescue events and a decreased need to escalate care," says Taenzer, an assistant professor of anesthesiology and pediatrics at Dartmouth Medical School (DMS).
In the study, personnel at Dartmouth-Hitchcock Medical Center (DHMC) monitored orthopaedic patients with finger probes that measure oxygen in the blood. The measurements went to a computer that notified nurses of physiological abnormalities. Such abnormalities often provide the first signs of a more serious situation developing.
"With an average length of stay of just over five days for patients transferred to the ICU, this saves our institution 135 ICU days per year in our 36-bed unit alone," says Taenzer, who practices in the PainFree program of the Children's Hospital at Dartmouth (CHaD). "Statistically, this worked out to a 65-percent reduction in rescue events and a 48-percent reduction in transfers to the ICU."
Ninety-eight percent of patients agreed to wear the oximetry probe and to undergo monitoring. According to Taenzer, nurses participating in the study commented that the surveillance system helped to increase their knowledge about the status of the patients under their care.
While the study focused mostly on elderly patients who had undergone orthopaedic surgery, Taenzer sees a much broader potential for the patient surveillance systems.
"Unrecognized adverse events affect patients in academic medical center settings as well as those in small community hospitals, and they affect patients who've had surgery as well as those who have not," he says, "Continuous patient monitoring represents a new area of research in patient safety, and we are optimistic that any patient admitted to a hospital may benefit."