Intra- and Extra-Hospitalization Monitoring of Vital Signs—Two Sides of the Same Coin: Perspectives from LIMS and Greenline-HT Study Operators

Abstract

Background: In recent years, due to the epidemiological transition, the burden of very complex patients in hospital wards has increased. Telemedicine usage appears to be a potential high-impact factor in helping with patient management, allowing hospital personnel to assess conditions in out-of-hospital scenarios. Methods: To investigate the management of chronic patients during both hospitalization for disease and discharge, randomized studies (LIMS and Greenline-HT) are ongoing in the Internal Medicine Unit at ASL Roma 6 Castelli Hospital. The study endpoints are clinical outcomes (from a patient’s perspective). In this perspective paper, the main findings of these studies, from the operators’ point of view, are reported. Operator opinions were collected from structured and unstructured surveys conducted among the staff involved, and their main themes are reported in a narrative manner. Results: Telemonitoring appears to be linked to a reduction in side-events and side-effects, which represent some of most commons risk factors for re-hospitalization and for delayed discharge during hospitalization. The main perceived advantages are increased patient safety and the quick response in case of emergency. The main disadvantages are believed to be related to low patient compliance and an infrastructural lack of optimization. Conclusions: The evidence of wireless monitoring studies, combined with the analysis of activity data, suggests the need for a model of patient management that envisages an increase in the territory of structures capable of offering patients subacute care (the possibility of antibiotic treatments, blood transfusions, infusion support, and pain therapy) for the timely management of chronic patients in the terminal phase, for which treatment in acute wards must be guaranteed only for a limited time for the management of the acute phase of their diseases.

Tecnologias para a consulta de enfermagem em emergência: revisão sistemática de literatura

“…A Telemedicina, uma das tecnologias mais evidenciada no estudo com (Pietrantonio et al, 2023;Blewer et al, 2016;Pratt et al, 2013), observados no quadro 2 este artefato se refere a prestação remota de serviços de saúde através da utilização de recursos tecnológicos e de telecomunicações para a troca de informações nos diferentes níveis de atenção à saúde, entre profissionais de saúde e entre médicos e pacientes (Santos et al, 2020). Ao permitir a troca de opiniões e experiências entre os profissionais da área, a telemedicina favorece a assertividade de diagnósticos e tratamentos (Oliveira et al, 2022).…”

“…Outros benefícios identificados também avultam-se como o aumento da segurança do paciente e a rapidez na resposta à emergência (Pietrantonio et al, 2023); disseminação e escalabilidade, autoeficácia no manejo da depressão (Blewer et al, 2016); melhora da comunicação, ganho de tempo diagnostico ; avaliação rápida de emergências químicas (Boltin et al, 2018).…”

“…Identificou-se também malefícios apresentados nos artigos pelo uso de tecnologias que necessitam ser analisados em outros estudos para redução destas ocorrências. A baixa adesão do paciente e a falta de estrutura (Pietrantonio et al, 2023) mostraram-se como uma das dificuldades para uma eficaz consulta de enfermagem em emergências.…”

Burden of delayed discharge on acute hospital medical wards: A retrospective ecological study in Rome, Italy

“…It must be noted however that such provisioning can be provided in both residential and homecare setting. Since home-based solution have already been proved the most optimal from both clinical and logistical point-ofview, a more proactive use of such setting is to be expected, even using novel approaches such as telemedicine and IT-based solutions [73][74][75].…”