Key result
Automated pupillometer documentation increases pupil assessment compliance to 65% vs 48% with manual entry.
Why the study?
Does automated documentation improve nurse compliance with quantitative pupillometer assessment standards in intensive care unit patients?
Cohort (n=351)
Does automated documentation improve nurse compliance with quantitative pupillometer assessment standards in intensive care unit patients?
Absolute Event Rate: 65% vs 47.7%
p-value: p=< 0.0001
Automated documentation significantly improves nurse compliance with evidence-based quantitative pupillometer assessments by reducing documentation burden.
BACKGROUND: Implementation research is focused on identifying barriers and facilitators to adopting evidence-based practices. Measuring pupil activity with a quantitative pupillometer (QP) has been repeatedly demonstrated to be a more evidence-based than subjective assessment of pupil reactivity. Yet, despite global availability, QP adoption is inconsistent. A possible influencing variable is documentation burden. PURPOSE: The purpose of this study is to explore whether technology that provides for automated documentation is a facilitator for implementing QP. METHODS: This institutional review board-approved study explored data that were documented manually (manual cohort) and data that were directly uploaded into the electronic health record (automated-upload cohort). Compliance with the unit-based policy for pupil assessment was determined for each 4-hour period of time during the patient's stay in the intensive care unit. RESULTS: There were no significant demographic differences between the 122 manual-entry cohort and 229 automated-entry cohort patients. The mean compliance in the automated-entry cohort of 65.0% (95% CI: 61.6-68.4%) was significantly higher than the mean compliance in the manual-entry cohort (47.7% [95% CI: 43.7-51.8%]; t = -6.42, P < 0.0001). IMPLICATIONS: A reduced documentation burden is associated with increased adoption of an evidence-based practice.
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Perera et al. (2026) conducted a cohort in Intensive care unit patients requiring pupil assessment (n=351). Automated documentation (direct upload into electronic health record) vs. Manual documentation was evaluated on Compliance with the unit-based policy for pupil assessment (p=< 0.0001). Automated documentation of quantitative pupillometer data significantly increased compliance with pupil assessment standards compared to manual entry (65.0% vs 47.7%; P < 0.0001).
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