Feasibility of continuous monitoring of vital signs in surgical patients on a general ward: an observational cohort study

Abstract

ObjectiveTo determine feasibility, in terms of acceptability and system fidelity, of continuous vital signs monitoring in abdominal surgery patients on a general ward.DesignObservational cohort study.SettingTertiary teaching hospital.ParticipantsPostoperative abdominal surgical patients (n=30) and nurses (n=23).InterventionsPatients were continuously monitored with the SensiumVitals wearable device until discharge in addition to usual care, which is intermittent Modified Early Warning Score measurements. Heart rate, respiratory rate and axillary temperature were monitored every 2 min. Values and trends were visualised and alerts sent to the nurses.OutcomesSystem fidelity was measured by analysis of the monitoring data. Acceptability by patients and nurses was assessed using questionnaires.ResultsThirty patients were monitored for a median duration of 81 hours (IQR 47–143) per patient, resulting in 115 217 measurements per parameter. In total, 19% (n=21 311) of heart rate, 51% (n=59 184) of respiratory rate and 9% of temperature measurements showed artefacts (n=10 269). The system algorithm sent 972 alerts (median alert rate of 4.5 per patient per day), of which 90.3% (n=878) were system alerts and 9.7% (n=94) were vital sign alerts. 35% (n=33) of vital sign alerts were true positives. 93% (n=25) of patients rated the patch as comfortable, 67% (n=18) felt safer and 89% (n=24) would like to wear it next time in the hospital. Nurses were neutral about usefulness, with a median score of 3.5 (IQR 3.1–4) on a 7-point Likert scale, ease of use 3.7 (IQR 3.2–4.8) and satisfaction 3.7 (IQR 3.2–4.8), but agreed on ease of learning at 5.0 (IQR 4.0–5.8). Neutral scores were mostly related to the perceived limited fidelity of the system.ConclusionsContinuous monitoring of vital signs with a wearable device was well accepted by patients. Nurses’ ratings were highly variable, resulting in on average neutral attitude towards remote monitoring. Our results suggest it is feasible to monitor vital signs continuously on general wards, although acceptability of the device among nurses needs further improvement.

Effect of Intelligent Vital Sign Monitoring System on Postoperative Nursing Care of Severe Patients

“…3AHcare, which has been researched and developed, integrates physiological parameters such as ECG, respiration, blood oxygen, blood pressure, and temperature into the same sensor chip. SD card is used to store data, and Zigbee or Bluetooth technology is used to transmit data to intelligent terminals for display, so as to realize daily monitoring of patients with chronic diseases in family and community environment [ 9 ]. Wireless ECG monitoring system based on body area network can collect patients' ECG data in real time and transmit them to mobile phone mobile terminals, and the system can analyze and mine the data to assist medical staff in monitoring patients' physiological information [ 10 ].…”

Screening for postoperative complications by continuous monitoring: protocol for the Biobeat-Postop cohort study

“…Our protocol seeks to specify the frequency of artefacts using both automatic detection with predefined bounds but also with review by clinicians as reported in a study concerning the feasibility of continuous monitoring of vital signs in surgical patients on a general ward using SensiumVitals patch. 21 This study showed a high percentage of artefacts concerning the respiratory rate measurement (51% of the measurements), and a lower percentage concerning the heart rate measurement (19%) and temperature (9%). This point is crucial as artefacts will generate false alarms leading to the rejection of the technique by caregivers.…”

Postbariatric EArly discharge Controlled by Healthdot (PEACH) trial: study protocol for a preference-based randomized trial

“…There are some studies that use the surgical patient as a research population. However, these are usually studies which take place in-hospital or in which the patient has been in the hospital for several days between surgery and discharge [27][28][29][30]. Therefore, Some limitations need to be addressed as well.…”