Development of a Lighted Infusion Line to Enhance Pediatric Critical Care

PROJECT SUMMARY Patients in the intensive care unit (ICU) represent the most critical of patients and admissions into the ICU are significantly increasing, thus creating a growing demand on critical care nurses that care for these patients. ICU nurses experience heightened workload, which can lead to missed nursing care, increased medical error. Nursing management of intravenous tubes and components (IVT) is a source of high workload and error. ICU patients often require several medications and the associated IVT become tangled making it difficult to identify the proper medication. Nurses rely on manual tracing of IVT to identify the proper line, which is difficult because the multiple IVT are indistinguishable, thus infusion errors occur. These errors are especially harmful to children as they are three times more likely to cause harm in pediatric patients compared to adults. There is a clear and unmet need for an improved method to quickly and accurately identify specific IVT in the ICU, especially for pediatric and neonatal patients, which would reduce the risk of error and improve patient outcomes. Lightengale seeks to address the burden of IVT management through the development of an illuminated IVT. Lightengale has developed an IVT with a light-diffusing fiber optic cable attached to the outer wall that glows when switched ‘on’, thus providing a visual cue for the entire length of the line from pump to patient. The Lightengale IVT has the potential to decrease time required to identify the IVT errors due to line confusion, and in turn improve nurse response time in critical situations. The goal of this Phase I proposal is to demonstrate proof-of-concept for the ability of the Lightengale IVT to reduce nurse workload. To meet this goal, a focus group consisting of nurses with intensive care experience will be used to explore aspects of current line management practices problems and evaluate the proposed prototype solution (Aim 1). The metric of success for Aim 1 is the execution of a critical care nurse focus group to identify nurse workload issues and potential prototype refinement needs. The Lightengale IVT will then be compared to a standard IVT in each of two simulation-based training (SBT) (Aim 2) during two distinct scenarios: 1) a patient at change of shift (while tracing lines during assessment) with sepsis diagnosis who has an acute deterioration; 2) a post-operative patient admitted to the ICU who has an acute deterioration. The metric of success for Aim 2 is for the Lightengale IVT to demonstrate a decrease in perceived workload and time-in-motion compared to the use of a standard IVT. Successful completion of the Phase I program will provide validation of the Lightengale IVT for enhancing nurse performance and support execution of a Phase II program involving a clinical study to demonstrate that use of the Lightengale IVT can reduce infusion medication delivery errors, which in turn will improve patient outcomes.NARRATIVE Patients in pediatric intensive care units often require multiple medications to be infused simultaneously. The intravenous tubing (IVT) delivering the medications often become indistinguishably entangled at the bedside. Current practice requires nurses to confirm medications by painstakingly tracing the IVT from pump to patient. This manual practice is time consuming and may lead to medication error, potentially causing patient harm. Lightengale seeks to address these errors with an innovative IVT that uses an attached light-emitting fiber-optic cable to light up the entire active line from pump to patient during tracing. Lightengale’s innovative solution has the potential to reduce errors in line tracing, thus improving patient outcomes.