Evaluation of an Ambient Color Coded Display to Communicate Changes in the Patient's Condition to ICU Nurses and Improve the Therapeutic Environment

Abstract

PROBLEM STATEMENT: For Intensive Care Units (ICUs) patients frequent noise, confusing patient monitors and loud alarms decrease the quality of stay, and may event extend its length. Nurses frequently enter the patient's room to check the patient monitor to become aware of changes, potentially disturbing patients and family. Ambient displays can communicate changes by subtly changing the environment, and have been shown to be unobtrusive and not disturbing to its users. An ambient display, visible from the doorway, would allow nurses to be aware of patient changes before alarms occur. OBJECTIVE: Our hypothesis is that color coded ambient displays using the standard vital sign colors are intuitively understood by clinicians and can communicate deviations in patient state. METHODS: We designed an ambient display, which communicates changes in patient's vital signs by changing its background color. A heuristic evaluation was performed, followed by an intrusive questionnaire of nurse without prior explanation of the color-coding. RESULTS: The results of the heuristic evaluation indicated that simultaneous changes could not be displayed. In the intrusive evaluation nurses correctly identified patient changes 73% of the time. Additionally, nurses correctly recalled 92% of vital sign colors used on their current patient monitor. DISCUSSION: Our findings confirm that color coded ambient displays using the standard vital sign colors are intuitively understood by clinicians and can communicate deviations in patient state. Future research needs to evaluate ambient displays in real ICU environments and identify nurses, patients' and families' reactions to such displays.