The Role of Off-shift Robotic Telerounding Between Physicians and Nurses in the Surgical Intensive Care Unit

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Lahey Clinic
ClinicalTrials.gov Identifier:
NCT01576614
First received: April 10, 2012
Last updated: September 24, 2013
Last verified: September 2013
  Purpose

Hypothesis: The use of a mobile robotic telepresence system for off-hours rounding in the surgical intensive care unit has an impact on nurse-physician collaboration.

Study question: Does the addition of mobile video communication provided by RTP affect nurse-physician collaboration during off shift rounding in the surgical intensive care unit when compared to the more common clinical practice of off-shift rounding using the telephone?


Condition Intervention
Off-shift Robotic Telerounding
Behavioral: Remote physician rounding

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: A Prospective Randomized Study on the Role of Off-shift Robotic Telerounding on the Collaboration Between Physicians and Nurses in the Surgical Intensive Care Unit

Further study details as provided by Lahey Clinic:

Primary Outcome Measures:
  • Collaboration and Satisfaction Survey About Care Decisions using CSACD Scores [ Time Frame: One Year ] [ Designated as safety issue: No ]
    This is a mixed-method study, involving both surveys and ethnographic fieldwork. The research team will utilize the Collaboration and Satisfaction About Care Decisions (CSACD) survey instrument at regular intervals to assess nurse-physician collaboration. The instrument is validated and reliable and has been extensively tested. Permission was obtained to use the instrument


Enrollment: 35
Study Start Date: August 2011
Study Completion Date: September 2013
Primary Completion Date: August 2013 (Final data collection date for primary outcome measure)
Groups/Cohorts Assigned Interventions
Nurse-Physician Rounding by Phone
The SICU's practice involves daily morning team rounding at the bedside. The team includes the critical care attending physician (AP), surgical resident physician, and critical care nurse. The AP is physically present in the SICU during these rounds and for the hours between approximately 7am and 7pm. During off-shift hours (7pm-7am), the AP is available by phone as the "on-call" attending physician. In addition to this on-call availability, the standard of practice in SICU for years has been that the on-call physician proactively places a telephone call to the SICU at least once every evening to perform "telephone rounds" with the resident physician aeach SICU patient.
Behavioral: Remote physician rounding
Use of Remote physician rounding using Remote Telepresence Robotics
Other Names:
  • RTP
  • Remote Telepresence Rounding
  • Telemedicne
  • Robotic rounds
Nurse-Physican rounding by R T P

Remote Telepresence Robotics (RTP) is a form of telemedicine that enables a fast and direct face-to-face response by a physician, located remotely, and may sometime utilize a mobile robot.

RTP provides the physician the ability to teleconference with patients and other healthcare providers using two way audio visual technology. The sophistication of these devices varies and can range from simple video conferencing to remote robotic control devices with audio visual conferencing capabilities. The "robotic" capabilities refer to ability of the physician to remotely direct or drive the device from one location to another.

The technology allows clinical experts to provide the right care at the right time and has become an accepted standard of care when used under appropriate circumstances.

Behavioral: Remote physician rounding
Use of Remote physician rounding using Remote Telepresence Robotics
Other Names:
  • RTP
  • Remote Telepresence Rounding
  • Telemedicne
  • Robotic rounds

Detailed Description:

This is a mixed-method study, involving both surveys and ethnographic fieldwork. The research team will utilize the Collaboration and Satisfaction About Care Decisions (CSACD) survey instrument at regular intervals to assess nurse-physician collaboration. The instrument is validated and reliable and has been extensively tested. Permission was obtained to use the instrument. The ethnographic investigation will run concurrently and be performed by a doctoral student from Massachusetts Institute of Technology (MIT). No part of the study will involve patient intervention. The study will be conducted in the surgical intensive care unit (SICU).

The survey-based portion of the study is a prospective, randomized, crossover-controlled trial; it will generate ordinal data regarding nurse-physician collaboration and satisfaction. The ethnographic portion of the study will involve observation and interviews. The MIT student will engage in unobtrusive observational shadowing of APs and nurses throughout the study, and will formally interview each observed AP and nurse twice during the entire length of the study: once at the onset of the study, and once as the study draws to conclusion. This observational shadowing will include visits to the SICU. All participants will be consented for the study. Consent for and implementation of these methods will be undertaken in a manner consistent with current best research practice; extensive measures will be taken to protect staff confidentiality.

  Eligibility

Ages Eligible for Study:   18 Years to 75 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population

Full time Nursing and Physician Staff providing rounding services in the Surgical Intensive Care Unit

Criteria

Inclusion Criteria:

  • Full time registered nursing staff
  • Resident physicians and critical care attending physicians

Exclusion Criteria:

  • Non-registered nursing staff
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01576614

Locations
United States, Massachusetts
Lahey Clinic
Burlington, Massachusetts, United States, 01805
Sponsors and Collaborators
Lahey Clinic
Investigators
Principal Investigator: Timothy N. Liesching, MD Lahey Clinic
  More Information

Additional Information:
No publications provided

Responsible Party: Lahey Clinic
ClinicalTrials.gov Identifier: NCT01576614     History of Changes
Other Study ID Numbers: 2011-071
Study First Received: April 10, 2012
Last Updated: September 24, 2013
Health Authority: United States: Institutional Review Board

Keywords provided by Lahey Clinic:
Comparing telephone VS RTP in SICU rounding practices

ClinicalTrials.gov processed this record on August 27, 2014