Heart Rate Variability for Practitioner Stimulated Reflection and Decision-making Optimisation

NCT07709364 | Not Yet Recruiting

• 2 other identifiers: P0317425/HRA/2201
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

At the heart of healthcare is the interaction between healthcare practitioners and patients. It is believed that optimisation of this interaction can improve patient relevant outcomes, safety and patient experience. Through utilisation of practitioner physiological data, heart rate variability (HRV), to help practitioners make better decisions and optimise practice, it is considered possible to improve decision making around patient care and improve outcomes and safety. The modern intensive care unit (ICU) is a dynamic data rich environment requiring rapid and accurate decision making. Advances in ventilator technology, electronic patient monitoring and electronic health records (EHR) have provided exponential growth in data produced for patients and the need for complex decision making. However, data overload and alarm fatigue can result in poor understanding and a delayed response from the practitioner in addressing the patient's needs. The aim of this study is to present and evaluate a psychophysiology training approach for practitioners derived from their cardiovascular response through the course of the working day, this will be measured using heart rate variability (HRV). Practitioner HRV has been shown to be linked to work related stress and is considered a biomarker of decision-making.

Conditions

Critical Care Nursing; Decision Making; Mechanical Ventilation; Cognition; Heart Rate Variability (HRV)

Keywords

Heart Rate Variability; HRV; Healthcare practitioner; Practitioner HRV

Outcome Measures

Primary Outcomes (2)

• Reduction in response time to ventilator patient physiological alarms

  Practitioner response time (in seconds) to ventilator-related physiological alarm events measured using ventilator event logs and bedside monitoring system records.

  At completion of 20th clinical shift (each shift is 12 hours)

• Adherence to bedside noise level targets

  Duration of time (seconds) bedside noise levels remain outside predefined acceptable clinical thresholds, measured using bedside environmental noise monitoring during clinical shifts.

  At completion of 20th clinical shift (each shift is 12 hours)

Secondary Outcomes (2)

• Improvement in practitioner heart rate variability during clinical practice

  At completion of 20th clinical shift (each shift is 12 hours)

• Participant-reported work effectiveness, job satisfaction, and stress levels

  At completion of 20th clinical shift (each shift is 12 hours)

Study Arms (1)

Bedside nurses in Enhanced Recovery Unit

EXPERIMENTAL

Baseline collection will consist of data from 20 bedside nurses over 10 shifts (12 hours +/- 3 hrs) each. 5 shifts post first intervention (1st workshop) and 5 shifts post second intervention (2nd workshop).

Behavioral: Critical Participatory Action Intervention with HRV Feedback

Interventions

Critical Participatory Action Intervention with HRV Feedback BEHAVIORAL

The intervention is based on a Critical Participatory Action Research learning model, using the participant's heart rate variability data collected during clinical shifts. Before the intervention, participants will complete repeated HRV monitoring and use a diary to record clinical events and reflections. The intervention includes facilitated workshops introducing reflective practice, cognitive bandwidth, and related educational concepts. Participants will receive individual coaching to review their HRV data and identify patterns and triggers in their clinical work, followed by group discussions to share experiences and develop strategies to adapt practice. A second workshop builds on this process with further reflection, additional HRV analysis, and collaborative strategy development. Between and after sessions, participants continue data collection and apply insights in practice, aiming to enhance clinical performance and develop a more context-aware approach to patient care.

Bedside nurses in Enhanced Recovery Unit

Eligibility Criteria

• Age: 21 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Nurse working in Enhanced Recovery Unit at Royal Papworth Hospital NHS Foundation Trust
• Willingness to participate in the trial

You may not qualify if:

• Staff with permanent pacemakers
• Staff on medication that could affect HRV (e.g. b-blockers)

Sponsors & Collaborators

• Papworth Hospital NHS Foundation Trust: lead

Study Sites (1)

Royal Papworth Hospital NHS Foundation Trust

Cambridge, Cambridgeshire, CB2 0AY, United Kingdom

Location

Study Officials

• Robert Gatherer, MBBS

  Royal Papworth Hospital NHS Foundation Trust

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Clinical Project Manager

CONTACT

01223638000; jeong-min.chun@nhs.net

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Model Details: Critical Participatory Action Research learning model, whereby practitioners can explore the nature and consequences of their practice utilising their HRV during two intervention periods.

Study Record Dates

• First Submitted: May 19, 2026
• First Posted: July 16, 2026
• Study Start: July 16, 2026
• Primary Completion (Estimated): June 1, 2027
• Study Completion (Estimated): June 1, 2027
• Last Updated: July 16, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)