Date Available

4-25-2022

Year of Publication

2022

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Sheila Melander

Clinical Mentor

Dr. Julia Blackburn

Committee Member

Dr. Candice Falls

Abstract

Abstract

Background: In April 2020, the University of Kentucky (UK) implemented a division entitled the Enhanced Care through Advanced Technology Intensive Care Unit (eCAT ICU) to provide tele-critical care (TCC) services in all critical care areas at UK Healthcare. The eCAT ICU at UK HealthCare was the first TCC delivery system of its kind in the state of Kentucky. Use of TCC has been associated with improved patient outcomes and decreased costs.

Purpose: The purpose of this study was to analyze targeted outcomes in the surgical critical care population pre- and post-implementation of TCC at UK HealthCare. Specifically, the aims of this study included a before and after analysis of the impact of TCC on hospital mortality, ICU mortality, hospital length of stay (LOS), ICU LOS, ventilator days, and ICU readmission within 48 hours of discharge.

Methods: A retrospective case-control design was employed for this study. Statistical analyses including t-test for equality of means were performed to examine changes in patient outcomes over a three-month period before and after implementation of UK’s eCAT ICU in March 2020.

Results: All targeted patient outcomes displayed small increases from 2019 to 2020. However, none of these increases met the criteria for statistical significance but some findings are clinically significant.

Conclusion: All targeted outcomes increased (worsened) from 2019 to 2020. However, the COVID-19 pandemic likely confounded study findings. Replication of this research is recommended that controls for the confounding factors experienced during a pandemic. Future research should examine the longitudinal effect of the eCAT ICU on patient outcomes, including a cost/benefit analysis for institutions using this innovative technology.

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