Heuristic Evaluation of ICU Mechanical Ventilators: A New Methodology for the Design of User Centered Interfaces

ABSTRACT Improving Quality and Reducing CostSESSION TYPE: Original Investigation SlidePRESENTED ON: Tuesday, October 29, 2013 at 02:45 PM - 04:15 PMPURPOSE: Mechanical ventilators (MV) are increasingly complex. Inadequate orientation and training on MV operation are associated to preventable deaths or injuries. The development of user-machine interfaces designed to facilitate cognitive processes may increase the ease of caregiver experience and reduce accidents. We propose a method of iterative design for an ICU MV (ix5, Intermed/CareFusion) by provision of feedback from usability tests, based on heuristic evaluation (HE), into design decisions.METHODS: The usability tests included the following procedures. 1.Users were defined as: physicians, respiratory therapists and nurses. Fifteen competencies were tested, for example: Turning on/off; Setting ventilation modes; Managing alarms; Monitoring mechanics; Using Non-Invasive Ventilation (NIV); etc.2. HE: Three experts on MV for each professional category individually performed specific tasks concerning the competencies above in a realistic simulated clinical scenario. The ASL 5000 simulator was adapted to a mannequin connected to the MV trying to reproduce a real ICU bed environment. All tests were filmed while the experts were oriented to "think aloud" during the process. A score sheet of the heuristics principles of Nielsen was filled in after discussion with the research team just after each test. The problems were classified as critical; important; minimum or esthetical. 3.The results were compiled, organized and presented to the manufacturer's engineers and designers. 4. An agenda for correction of the problems was set. 5. The process is repeated with the modified interface.RESULTS: The experts were concordant that the ix5 interface could change to: Induce adjustments based on the patient's ideal body weight; Facilitate measurements of respiratory mechanics; Help in alarms interpretation and troubleshooting; Facilitate NIV settings; Facilitate data interpretation by showing only 5 to 6 parameters in the MV display at the same time. These indications for improvement are now being incorporated into a new interface for the ix5 MV.CONCLUSIONS: The HE seems to be a feasible method for usability testing of MV.CLINICAL IMPLICATIONS: Improvements in the care of mechanically ventilated patients are to be expected by use of MV designed with this new methodology.DISCLOSURE: Marcelo Holanda: Grant monies (from industry related sources): i have received an scholarship for this resarch José Lonardoni: Employee: Design engineer Jorge Bonassa: Shareholder: Director The following authors have nothing to disclose: Nathalia Parente de sousa, Raquel SalesThe work provides an original methodology for testing the usability of ICU mechanical ventilators.