Clinical implementation of a new technology: provider perspectives and perceived effects of an incentive spirometer patient reminder

Pangborn, Joshua

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Year:: 2019
Contributor:: Pangborn, Joshua (creator); Blume, Janet (Reader); Garcia, Dioscaris (Reader); Daniels, Alan (Advisor); Brown University. Biology and Medicine: Biomedical Engineering (sponsor)
Genre:: theses
Subject:: Clinical trials; Incentive spirometer; device development
Extent:: 9, 20 p.
DOI: https://doi.org/10.26300/1yy4-rt94

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Abstract:: Author: Pangborn, Joshua, A Institution: Brown University Title: Clinical implementation of a new technology: provider perspectives and perceived effects of an incentive spirometer patient reminder Committee Chair: Alan Daniels, M.D. Background: Incentive spirometry non-compliance may worsen clinical outcomes. In an attempt to improve such IS non-compliance, the authors developed an incentive spirometer patient reminder device (SpiroTimer). A recent randomized controlled trial (RCT) demonstrated that the SpiroTimer improved compliance and clinical outcomes (supplemental oxygen requirements, length of hospital stay, and 6-month mortality) without affecting provider workload. For any new device to be clinically adopted, providers must support the device’s use. The goal of this investigation was to 1) compare providers’ perceptions of SpiroTimer’s effects to its demonstrated effects and 2) evaluate providers’ perspectives on the clinical implementation of the SpiroTimer. Methods: Following the completion of the RCT of the SpiroTimer but before the providers were informed of the results of the RCT, a 29-question survey was distributed in-person to all nurses involved in the trial. Perceptions of SpiroTimer’s effects were compared to its effects demonstrated in the clinical trial. Perspectives on the implementation of the SpiroTimer were assessed. Results: Results include the responses from 52 nurses (100% response rate) that participated in the RCT trial. In general, the majority of nurses feel IS use-compliance is poor (65%) and should be improved (94%). Providers agree the reminder improved patient IS use compliance (82%), IS effectiveness (74%), and patient engagement in their own care (88%). Nurses reported the SpiroTimer reduced the number of times the nurses had to remind patients to use their IS (70%), reduced IS-related workload (58%), helped remind the nurses to work with patients on IS (70%), and that the SpiroTimer was overall helpful (72%). The majority of nurses agree that the SpiroTimer specifically addresses patients who forget to use their IS (96%), patients who do not know when to use their IS (80%), and patients who do not use their IS frequently enough (84%). Discussion: Although providers viewed the SpiroTimer to be clinically useful, the full extent of the device’s benefits were not encompassed by the 72% of nurses who agreed that the SpiroTimer was overall helpful since its main benefits (e.g., reducing the number of times nurses had to remind and educate patients) apply mostly to a certain set of patients (those who forget to use their IS or do not know how). Even a reduction in the time nurses spend with this particular set of patients could add up to a significant amount. Financially, hospitals would reduce costs associated with incentive spirometry. Providers recommend the SpiroTimer should be used. With greater use of the incentive spirometer patient reminder, the device’s clinical benefits to patients may be fully appreciated by providers.
Notes:: Thesis (Sc. M.)--Brown University, 2019

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Rights: In Copyright
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Pangborn, Joshua, "Clinical implementation of a new technology: provider perspectives and perceived effects of an incentive spirometer patient reminder" (2019). Biomedical Engineering Theses and Dissertations. Brown Digital Repository. Brown University Library. https://doi.org/10.26300/1yy4-rt94

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Biomedical Engineering Theses and Dissertations

Theses and Dissertations for the Biomedical Engineering department.
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