Randomized Trial of Intelligent Sensor System for Early Illness Alerts in Senior Housing

Rantz, Marilyn; Phillips, Lorraine J.; Galambos, Colleen; Lane, Kari; Alexander, Gregory L.; Despins, Laurel; Koopman, Richelle J.; Skubic, Marjorie; Hicks, Lanis L.; Miller, Steven J.; Craver, Andrew; Harris, Bradford H.; Deroche, Chelsea B

doi:10.1016/j.jamda.2017.05.012

Cited by 53 publications

(56 citation statements)

References 33 publications

(38 reference statements)

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“…Similarly, Reeder et al (2013) noted the effectiveness of systems that included an activity sensing component. Rantz et al (2017b), through a randomised clinical trial, demonstrated the positive health outcomes of in-home monitoring technology aimed at the early detection of health status changes in older adults. Studies 15 also indicated that monitoring systems can prolong the length of stay in independent living residences, thus supporting aging in place and reducing care costs by postponing the need for institutional care (Rantz et al, 2015;Riikonen et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

“…The 35 algorithm design was informed by clinicians to enhance the clinical relevance of the system . As the system was continuously improved based on users' feedback, clinicians' perception of its clinical relevance increased over time (Rantz et al, 2017b). Clinicians were also involved in other aspects of the system design such as informing user interface design to improve usability (Alexander et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

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Integration of an in-home monitoring system into home care nurses’ workflow: A case study

Klemets

Määttälä

Hakala

2019

International Journal of Medical Informatics

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BackgroundThe healthcare system faces a major challenge in caring for an increasingly ageing population as this task requires more resources than are currently available. Adopting monitoring technologies could enable more efficient care practices and support ageing in place.Objectives To investigate how the use of an in-home motion monitoring system can be integrated into home care nurses' workflows and to uncover the factors behind system adoption.Design A single case study adopting a qualitative approach.Setting A home care unit serving older adults living in independent living residences within an apartment complex.Method Multiple data collection methods were used including individual and group interviews, a questionnaire with open-ended questions, evaluation probes, and system log data. The qualitative material was analysed using a stepwise-deductive inductive approach.Results A central factor behind system adoption was the perceived usefulness of gaining information about older adults' night-time activities. In particular, monitoring older adults suffering from memory disorders was considered advantageous. The information that the system provided supported nurses in health assessments and assisted in adjusting care decisions. Previous negative experiences with similar technologies initially influenced the time for adoption. Further, although nurses were closely involved in the system design process, they took some time to get acquainted with the system and to integrate its use into daily practice. System reliability and accuracy issues influenced nurses' trust in the sensory data.Conclusion The findings suggests that in a home care setting, focusing on motion pattern monitoring for older adults with memory disorders can provide significant benefits and therefore also facilitate system adoption among nurses. Involving nurses in the design of the technology and providing opportunities to trial the system in real practice also appear to be important in achieving system adoption. 65 compatibility, complexity, trialability, and observability (Rogers, 1983). Relative advantage refers to how potential users perceive the innovation as an advantage over existing alternatives. For example,

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Integration of an in-home monitoring system into home care nurses’ workflow: A case study

Klemets

Määttälä

Hakala

2019

International Journal of Medical Informatics

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“…Within the robotics category, two thirds of the studies and all RCTs focus on the robotic seal Paro, so this is one of the few technologies that is quite extensively researched; nevertheless most of the studies are rather small. In the monitoring/sensors category there are only four RCTs, of which only two report positive results on pressure ulcer prevention [112] and behaviour analysis for care decision support respectively [120]. Still there are several quasi-experimental studies, most of which yield positive results, which may point to promising future research areas.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of digital technologies to support nursing care: results of a scoping review

Hüter

Krick

Domhoff

et al. 2020

Preprint

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Background The field of digital technologies being developed or applied to support nursing care is very extensive. The aim of this scoping review is to provide an overview on technologies for which results on positive or negative effects on persons in need of care, caregivers or care institutions are available – and to appraise the reliability of these results. An additional focus is put on the question which care settings and target groups have been addressed by the research so far. Methods A scoping review design has been used to identify studies focussing on the effectiveness of digital technologies in nursing care for persons in need of care, caregivers or care institutions. The screening process included 19.510 scientific publications from 9 databases. Results A total of 123 single studies and 31 reviews were subjected to the analysis. The range of technologies that is researched to support nursing care is wide. The included technologies comprise nursing and health information technologies, such as assistive devices, information and communication technologies (including decision support systems, electronic health records, hospital and nursing home information systems), sensors and robotic technologies. The results show that there are many studies that demonstrate positive effects of the technologies, but the level of evidence is mostly low and study sizes are often small. Hardly any technology has been researched intensively enough to produce conclusive results. Studies on a high level of evidence (RCTs) lack for nearly all technological areas. Heterogeneous results in some areas indicate that effects may depend strongly on the mode and and specific context into which the technologies are introduced. Most studies are situated in inpatient care settings. Conclusion Due to the limited evidence on effectiveness of digital technologies in nursing care, it is not surprising that care institutions are reluctant to put innovative technologies into practice. The scoping review indicates technology areas that should be subject to future research with higher quality studies. Research on outpatient care settings, informal care arrangements and cross-sectoral care should be intensified to further exploit the potential of digital technologies to improve independence of care-recipients and unburden formal an informal carers.

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“…Ten studies were conducted in the USA, 47,169,176,210,222,227,230,[299][300][301] two in Australia, 203,274 two in New Zealand 166,236 and one in each of Belgium, 54 Canada, 147 Italy, 101 Japan, 250 Singapore, 163 Norway, 160 Taiwan, 177 the Netherlands 56 and the UK. 277 Thirteen randomised studies were included (six individually randomised parallel group trials, two individually randomised crossover trials and five cluster randomised trials), 47,54,101,147,160,177,203,210,230,236,274,277,299 as were 11 non-randomised studies of interventions. 56,161,163,166,168,169,176,222,227,250,300,301 Details of the studies included in this systematic review are shown i...…”

Section: Findings Of Systematic Evidence Synthesismentioning

confidence: 99%

Innovation to enhance health in care homes and evaluation of tools for measuring outcomes of care: rapid evidence synthesis

Hanratty

Craig

Spilsbury

et al. 2019

Health Serv Deliv Res

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BackgroundFlexible, integrated models of service delivery are being developed to meet the changing demands of an ageing population. To underpin the spread of innovative models of care across the NHS, summaries of the current research evidence are needed. This report focuses exclusively on care homes and reviews work in four specific areas, identified as key enablers for the NHS England vanguard programme.AimTo conduct a rapid synthesis of evidence relating to enhancing health in care homes across four key areas: technology, communication and engagement, workforce and evaluation.Objectives(1) To map the published literature on the uses, benefits and challenges of technology in care homes; flexible and innovative uses of the nursing and support workforce to benefit resident care; communication and engagement between care homes, communities and health-related organisations; and approaches to the evaluation of new models of care in care homes. (2) To conduct rapid, systematic syntheses of evidence to answer the following questions. Which technologies have a positive impact on resident health and well-being? How should care homes and the NHS communicate to enhance resident, family and staff outcomes and experiences? Which measurement tools have been validated for use in UK care homes? What is the evidence that staffing levels (i.e. ratio of registered nurses and support staff to residents or different levels of support staff) influence resident outcomes?Data sourcesSearches of MEDLINE, CINAHL, Science Citation Index, Cochrane Database of Systematic Reviews, DARE (Database of Abstracts of Reviews of Effects) and Index to Theses. Grey literature was sought via Google™ (Mountain View, CA, USA) and websites relevant to each individual search.DesignMapping review and rapid, systematic evidence syntheses.SettingCare homes with and without nursing in high-income countries.Review methodsPublished literature was mapped to a bespoke framework, and four linked rapid critical reviews of the available evidence were undertaken using systematic methods. Data were not suitable for meta-analysis, and are presented in narrative syntheses.ResultsSeven hundred and sixty-one studies were mapped across the four topic areas, and 65 studies were included in systematic rapid reviews. This work identified a paucity of large, high-quality research studies, particularly from the UK. The key findings include the following. (1) Technology: some of the most promising interventions appear to be games that promote physical activity and enhance mental health and well-being. (2) Communication and engagement: structured communication tools have been shown to enhance communication with health services and resident outcomes in US studies. No robust evidence was identified on care home engagement with communities. (3) Evaluation: 6 of the 65 measurement tools identified had been validated for use in UK care homes, two of which provide general assessments of care. The methodological quality of all six tools was assessed as poor. (4) Workforce: joint working within and beyond the care home and initiatives that focus on staff taking on new but specific care tasks appear to be associated with enhanced outcomes. Evidence for staff taking on traditional nursing tasks without qualification is limited, but promising.LimitationsThis review was restricted to English-language publications after the year 2000. The rapid methodology has facilitated a broad review in a short time period, but the possibility of omissions and errors cannot be excluded.ConclusionsThis review provides limited evidential support for some of the innovations in the NHS vanguard programme, and identifies key issues and gaps for future research and evaluation.Future workFuture work should provide high-quality evidence, in particular experimental studies, economic evaluations and research sensitive to the UK context.Study registrationThis study is registered as PROSPERO CRD42016052933, CRD42016052933, CRD42016052937 and CRD42016052938.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Randomized Trial of Intelligent Sensor System for Early Illness Alerts in Senior Housing

Cited by 53 publications

References 33 publications

Integration of an in-home monitoring system into home care nurses’ workflow: A case study

Integration of an in-home monitoring system into home care nurses’ workflow: A case study

Effectiveness of digital technologies to support nursing care: results of a scoping review

Innovation to enhance health in care homes and evaluation of tools for measuring outcomes of care: rapid evidence synthesis

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