Non-contact Health Monitoring to Support Care in a Psychiatric Intensive Care Unit

Abstract

Objective: Psychiatric intensive care units provide care to patients with severe mental health disorders, often associated with violence and aggression which may result in the administration of rapid tranquillisation (RT). Novel technologies may support staff in monitoring patient safety and intervening proactively to prevent assaults and RT. The objective of this single-centre pragmatic study was to assess the effect of clinical teams augmenting their existing clinical practices with a contact-free vision-based patient monitoring system on the number of assaults and RT events.Method: The number of incidents of assaults, and the associated use of RT, was examined before and after the introduction of a contact-free vision-based patient monitoring system in a male psychiatric intensive care unit. Staff surveys and interviews were undertaken to assess usability and acceptability of the system.Results: There was a 37% reduction in assaults across the wards with 26% reduction in bedroom assaults. There was a 40% reduction in RT episodes related to assaults. Staff reported that they felt confident in monitoring the physicalsigns and health of patients remotely with the contact-free vision-based patient monitoring system to support them.Conclusion: The results suggest that the contact-free vision-based patient monitoring system helped staff to reduce incidents of assaults and associated RT administration. Staff surveys and interviews showed the ways in which their use of this technology had supported them in physical health monitoring.

The use and impact of surveillance-based technology initiatives in inpatient and acute mental health settings: A systematic review

“…Five papers (18.5%) disclosed conflicts of interest. One report produced by a surveillance technology company [53], while other conflicts of interest included the project being funded by a surveillance technology company [40,49], authors' time being funded by a technology company [44,51] or authors working for a surveillance technology company [40,51]. Out of the 27 studies included in this review, we also identified potential undeclared conflicts of interest in two studies.…”

“…All were UK-based and utilised Oxevision (a VBPMM device by Oxehealth). Four of the six studies reported conflicts of interest [40,49,51,53]. All studies were rated as low quality except one which was rated high quality [42].…”

“…aiding monitoring of self-harm risks [51], preventing incidents [42], supporting care-planning [53];…”

“…Three studies reported VBPMM implementation outcomes [37,49,51]. Barrera et al [37] reported high fidelity, with no significant gaps in VBPPM use and staff observations being conducted as required, and high penetration, stating that the sensors appeared to be embedded in the ward's day-to-day clinical practice.…”

“…However, concerns included patients misusing them as ligatures or weapons, exacerbating patient paranoia, data security and patient confidentiality issues, fluctuating patient willingness to use them and increased workload for staff. Five papers explored post-implementation experiences of VBPMM [37,40,42,51,53] (see Table 7 for full results). Three of these studies reported conflicts of interest [40,51,53].…”