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NCT Number: NCT07709364

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

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.

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Key information

Conditions

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

Age range

21 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Royal Papworth Hospital NHS Foundation Trust

Cambridge, Cambridgeshire, CB2 0AY, United Kingdom

Location contact

Robert Gatherer, MBBS

CONTACT

[email protected]

01223638000

Robert Gatherer, MBBS

PRINCIPAL_INVESTIGATOR

About this study

A Critical Participatory Action Research learning model is proposed, whereby practitioners can explore the nature and consequences of their practice utilising their HRV during two intervention periods. The aim is to improve practitioner performance and develop a more context aware approach to patient care.

Impact will be measured through:

  • improvement in HRV of the practitioners
  • measurement of response times to ventilator related events (decreased response times)
  • improvement of time spent at bedside
  • improvement in ventilation related outcomes for the patients.
  • Reduction in bedside noise (reduced response time to alarms and reduction in inappropriate alarms)

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

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

Exclusion criteria

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

Treatment and study plan

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.

Primary outcomes

  1. Reduction in response time to ventilator patient physiological alarms

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

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

  2. Adherence to bedside noise level targets

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

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

Secondary outcomes

  1. Improvement in practitioner heart rate variability during clinical practice

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

    Can practitioners improve their HRV through the iterative stimulated reflection intervention.

  2. Participant-reported work effectiveness, job satisfaction, and stress levels

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

    Participant-reported perceptions of work effectiveness, job satisfaction, and stress levels measured using study questionnaires

Study contacts

Contact information is provided by the study sponsor or research team.

Clinical Project Manager

CONTACT

[email protected]

01223638000

Sponsors and collaborators

Lead sponsor

Papworth Hospital NHS Foundation Trust

Other Gov

Registry information

Acronym: HRV-PRO

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Jul 16, 2026
Registry last updated
Jul 16, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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