The eICU: Big Brother or Team Member?

Virtual Reality Headset Prototype (circa 1968). Photo by Pargon, via Flickr.

Virtual Reality Headset Prototype (circa 1968). Photo by Pargon, via Flickr.

By Peggy McDaniel, BSN, RN

There is an intriguing new technology available to hospital ICUs. It’s called an eICU.  At Alegent Health in Omaha, Nebraska, the “software feeds real time data for roughly 100 patients, including vital signs, laboratory tests, cultures, and pharmacy data,” to nurses and a doctor monitoring the eICU from off site. Using the data, the software sets off alerts that are noted by the eICU staff and passed on to the bedside staff. The bedside clinicians have said that the extra help has allowed them to focus on bedside care.

About two years into its use, an interesting side benefit of this remote monitoring system was noted by the hospital’s director of infection control. She realized that the eICU allowed her to monitor and promote compliance to practice bundles as well as to compile data to promote better antimicrobial measures.

The article reports that the staff initially felt a bit concerned about being watched by “big brother.” However, the hospital promoted the idea of the eICU as a “part of the team” instead of an intrusion, an approach that appears to have been successful.

As a nurse who works to improve compliance to best practices that reduce hospital-acquired conditions, particularly bloodstream infections, I feel this presents an amazing opportunity to promote patient safety.  For example, when I perform hospital audits, I see poor compliance to hand washing and the cleansing of IV access ports. These two practices are proven to help decrease the spread of infection, but compliance remains low. Educating staff about why compliance matters does help, but results are often best when a “carrot and a stick” are both used to motivate staff.

What do you think of this type of technology? Do you feel this expensive technology will be readily adopted? Does it make you uncomfortable? Let us know what you think.

(For a different perspective on eICUs, one focused on the issue of inadequate nurse staffing, see this post from AJN‘s interim editor in chief, Shawn Kennedy.)

Bookmark and Share

Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.


  1. Darlen November 17, 2009 at 3:34 pm

    We absolutely love our eICU where I work. Our patient mortality is lower, we feel we have a Dr. there to give us immediate orders when needed and we discuss how to better take care of our patients with them. There is no big brother issue at all, it’s a team effort with our staff of nurses and the eICU.

  2. jm November 6, 2009 at 3:44 pm

    EDITOR’s NOTE: an article published on Nov. 2 at the Robert Wood Johnson Foundation notes the following possible benefits of eICUs: “The use of remote intensive care unit (ICU) monitoring systems to track patients receiving critical care may help hospitals address a growing shortage of intensivists while reducing costs and mortality, the Wall Street Journal reports.”

  3. Peggy October 20, 2009 at 6:40 pm

    Maybe we nurses should take note… why does it take constant surveillance and reminders to get us to do the most basic of things, such as wash our hands?? Since technology is here to stay, why not let it help us instead of seeing it as something to work around?

  4. Christine October 19, 2009 at 1:00 pm

    No matter how management rolls out eICU, they will certainly be thought of as big brother looking over their shoulder because big brother is introducing the idea. Over time eICU may become more like the security cameras, something that you see every day but really don’t care about unless you need it.

Comments are moderated before approval, but always welcome.

%d bloggers like this: