Table 2

SA debrief comments

Comment categoryTechnologyWorkflow
Positive comments
  • Improved speed and efficiency of SA compared with manual system

  • User-friendly and convenient

  • Safe, trustworthy and accurate

  • Appreciated ability to double check SA or use it to double check nurses’ work

  • Belief that trust and comfort with SA would increase with more time and use

  • SA helped to avoid the major barrier of finding a second nurse for a double check

  • SA would be useful given ICU business and high workload

Neutral comments
  • SA similarly easy to use as manual system

  • SA similarly safe as manual system

  • Safety, efficiency and utility of SA would depend on interuser variability in trust and workload

Perceived barriers to use
  • Concern about SA’s ability to integrate proper data and correctly run algorithm

  • Concern about pump-SA interoperability

  • EMR downtime, Wi-Fi connectivity and glucometer syncing issues

  • Confusing display

  • Discomfort with lack of a second nurse

  • Uneasiness with new technology and electronic protocols in general

  • Concern that SA would induce laziness among clinicians, loss of skills or lack of awareness of patient conditions and trends

  • Necessary for nurses to double check SA

Suggestions for improvement
  • Display of blood glucose values linearly from oldest to newest

  • Display data and protocol side-by-side

  • Occupy larger portion of the screen

  • Decrease lag time from pump to EMR

  • Create an SA tab in EMR

  • Link to SA in the MAR and redirection to the MAR after dose confirmation in SA

  • Link to SA in the flowsheets

  • Generate alert when dose check is required

  • EMR, electronic medical record; ICU, intensive care unit; MAR, medical administration record; SA, smart agent.