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Telehealth Intensive Care Unit Nurse Surveillance of Sepsis

Rincon, Teresa A. BSN, RN; Manos, E. LaVerne DNP, RN-BC; Pierce, Janet D. PhD, APRN, CCRN, FAAN

CIN: Computers, Informatics, Nursing: September 2017 - Volume 35 - Issue 9 - p 459–464
doi: 10.1097/CIN.0000000000000355

The purpose of this article is to describe the usability and human factors engineering standards used in development of a sepsis alert known as the sepsis prompt. Sensory processing, cognitive processing, signal detection, criterion response, and user satisfaction were evaluated with controlled user testing and critical incident response techniques. Nurses reported that the sepsis prompt was visible and distinct, making it easily detectable. The prompt provided a clear response mechanism and adequately balanced the number of false alerts with the likelihood of misses. Designers were able to use a mental model approach as they designed the prompt because the nurses were already using a manual sepsis detection process. This may have predisposed the nurses to response bias, and as such, they were willing to accommodate more false alarms than nurses who are not familiar with sepsis screening (surveillance). Nurses not currently screening for sepsis may not place the same value on this alert and find it an annoyance. The sepsis prompt met usability standards, and the nurses reported that it improved efficiency over the manual screening method.

Author Affiliations: School of Nursing, University of Kansas (Ms Rincon, Dr Manos, Dr Pierce); and University of Massachusetts Memorial Medical Center (Ms Rincon), Worcester.

T. Rincon has served and continues to serve in advisory and speaking roles for Philips Healthcare. Philips Healthcare provided no funding or contribution to the evaluation of the prompt or the writing of this article. The findings of this evaluation do not reflect the opinions of Philips Healthcare.

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

Corresponding author: Teresa A. Rincon, BSN, RN, eICU, University of Massachusetts Memorial Medical Center, 20 Siani Rd, Rochdale, MA 01542 (

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