The Computer Assisted Labor Monitoring Suite for Obstetrics (CALM)

Tracy Whitman

Objectives Describe CALM Suite Describe Hardware List, Describe, and Evaluate software Describe and review the information system Describe advantages and disadvantages Examine related ethical/legal issues Describe the technology-related competencies of

the professional nurse working with CALM Suite Describe the functions of the informatics nurse

working with CALM Suite

CALM Suite Description

CALM Suite is a base fetal monitor surveillance and archival system that:

Allows nurses to view patients from different locations

Electronically documents patient data and capture vital signs

Contains embedded clinical decision support tools that identify and label fetal monitor patterns (LMS Medical, 2005)

CALM Suite Description CALM Suite provides for the consistent

and objective management of obstetrical units

CALM Suite includes:Central fetal surveillance and alertsMaternal – fetal chartingAggregated reportingArchivingRemote access

(LMS Medical)

Hardware Monitors

1. Corometrics 116, Corometrics 118, Corometrics Series 120 models

2. Hewlett Packard Models HP50XM, HP501P

3. Toitu MT430

Hardware description

Corometrics 120 Series Maternal Fetal Monitors

Records: Dual fetal heart rates Uterine activity Maternal vital signs Fetal pulse oximetry

(Wipro GE Healthcare, 2003)

Software CALM Curve CALM Patterns CALM Shoulder Screen

Software description

CALM Patterns: Provides impartial tracing analysis (of

fetal heart rate) while highlighting significant trends

(LMS Medical)

Software description cont.Key Features:CALM Patterns Tracing: Labels and measures standard fetal heart rate

Accelerations Decelerations

Late, Early, Variable typical, Variable atypical Patterns are marked with:

Color, letters, icons Beginning and ending date Time range

CALM Patterns Contractility: Detection of uterine contractions from the monitor

(LMS Medical)

Software description cont.

Key Benefits Brings American College of Obstetricians and

Gynecologists (ACOG) definitions to the bedside

Numeric values for easy review Improves communication Constant educational reinforcement Automatic data input 2 hours of tracings for trend identification

(LMS Medical)

Usability of the software“Train the Trainer” approach:

Trained super users, administrators and basic users First line of clinical support nearby Complete user guide Access to “how to” section for in-depth explanationYour Current IT investment: Works with monitors, PC’s, servers, networks and software

already in place.Ensure Team Acceptance and Usage of the System: Easy to use interface Configured based on OB teams preferences and work methodsCALM ensures usability by: Being highly accessible Users can see patient data from the bedside, workstation,

lounge or remotely

I hope this is

easy to

use!!

(LMS Medical)

Usability of the software cont.

Provide ease of interoperability HL7 interface Enable’s data sharing between other obstetrical

information systems Fulfill the departments current needs

while considering the future Ensure system performance and ease of

installation

(LMS Medical)

Description of Information System

LMS Medical Systems is a healthcare technology company specializing in computer software for obstetrical management. The CALM Clinical Information System (CIS) houses intelligent tools in specialized software.

CALM CIS Includes: Central fetal surveillance and alerts Maternal-fetal charting Aggregate reporting Archiving Remote access

(LMS Medical)

Description of Information System cont.

The Calm suite comprises many modules.

1. CALM Curve (analysis of labor progression)2. CALM Patterns (helps to identify the fetus at

risk for brain injury from oxygen deprivation)3. CALM Shoulder Screen (estimates the risk for

shoulder dystocia)

(LMS Medical)

Information System Review Summary CALM Clinical Information System Used by doctors and nurses Functions

Electronic medical record keeping Surveillance Alerts and archiving Display of fetal monitoring records Web accessibility Decision support modules

Accessibility At the bedside Central monitoring Workstations Remotely from home or the physicians office

Health Level 7 (HL7)

(LMS Medical)

Advantages Optimizes patient safety Three tiered security Improves communication between

physicians and nurses Long-term data storage Fetal and maternal surveillance and alerts

(LMS Medical)

Advantages cont. Central monitoring Improving outcomes and reducing errors

in obstetrics Uses evidence-based approach to

obstetrics

(LMS Medical)

Disadvantages

Adapting to new software

Troubleshooting problems

Staff opposition to change

Financial

Ethical Issues Neonatal brain injury Birth asphyxia

(Bracci, Perrone, & Buonocove, 2006)

Legal Issues

50% of all malpractice cases with damages over 1 million dollars are in obstetrics.

Most involve birth-related brain injury

Medical errors play a role in 30-50% of cases.

Teams are held accountable even if antepartum conditions contributed to the injury.

(LMS Medical)

Informatics Competencies

Uses computerized patient monitoring systems Identifies the basic components of a computer

system Recognized that a computer program has

limitations Defines the impact of computerized information

management Applies monitoring system appropriately Performs basic troubleshooting

(McGonigle & Mastrian, 2009)

Functions and Responsibilities

Demonstrates fluency in informatics and nursing technologies

Implements and evaluates application/system training programs for users

Determines projected impacts to users and organizations

Applies human factors and ergonomics to the design of the hardware and software

(McGonigle & Mastrian)

Summary

Prevent birth related injuries by: Recognizing Anticipating Communicating Intervening

With regards to: Abnormal fetal heart rate tracings Prolonged labor Shoulder dystocia

(LMS Medical)

ReferencesLMS Medical (2005). The CALM Suite for Obstetrics. Retrieved January 25, 2009, from

http://www.lmsmedical.com/4105/03_03_the_calm_suite_for_obstetrics.aspWipro GE Healthcare (2003). Monitoring Systems. Retrieved February 21, 2009, from

http://www.gehealthcare.com/inen/monitor/products/interpartum/coro120_info.htmlMcGonigle, D., & Mastrian, K. (2009). Nursing Informatics and the Foundation of

Knowledge. Sudbury, MA: Jones and Bartlett Publishers.Rodolfo Bracci, Serafina Perrone, Giuseppe Buonocore. "The Timing of Neonatal Brain

Damage. " Biology of the Neonate  90.3 (2006): 145-55. Health Module. ProQuest.  University Park,  PA. 23 Feb. 2009 <http://www.proquest.com/>