Effectiveness of a Computer Application in Improving Pulmonary Artery Catheter Waveform Interpretation

Skill with pulmonary artery catheter (PAC) waveform interpretation is inadequate among physicians and nurses. We, the investigators at Massachusetts General Hospital, have developed a web-based computer program to assist physicians and nurses in PAC waveform interpretation. We will study the effectiveness of this program on improving the interpretation of waveforms on a computer-based test.

The pulmonary artery catheter (PAC) guides diagnosis and treatment in the intensive care unit (ICU), but studies have shown that physicians and nurses collectively have inadequate skill in interpreting PAC waveforms. We have developed a Web-based application that provides physicians and nurses with rapid access to relevant PAC-related content for use in patient care situations. The application begins with a visual index that assists clinicians in the recognition of both normal and abnormal waveforms and provides waveform-specific links to concise advice on making accurate pressure measurements, troubleshooting system problems, and avoiding complications of catheter use. Initial evaluation will consist of a before-and-after trial to determine whether the application improves test performance in the areas of waveform recognition, accuracy of measurement, and appropriateness of action. Once the resource is in production, we will electronically log usage and survey users to evaluate the extent and effect of actual utilization.

Inclusion Criteria:

• Critical care nurses
• House officers rotating through the medical Intensive Care Unit
• Fellows rotating through the medical Intensive Care Unit