Using Continuous Vital Sign Monitoring to Detect Early Deterioration in Adult Postoperative Inpatients

Verrillo, Sue Carol; Cvach, Maria; Hudson, Krysia Warren; Winters, Bradford D.

doi:10.1097/ncq.0000000000000350

Cited by 38 publications

(42 citation statements)

References 10 publications

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“…Five studies (N=1308) have been published about the ViSi Mobile (Sotera Wireless; Table 1 ) [ 39 , 40 , 51 , 59 , 60 ]. This device is worn on the wrist, upper arm, or chest, and it measures HR, RR, BP, SpO 2 , and skin temperature ( Table 2 ) [ 66 ].…”

Section: Resultsmentioning

confidence: 99%

“…Feasibility outcomes: Patients reported the wristband as big or heavy. Four studies reported the perceptions of the health care professionals [ 39 , 51 , 59 , 60 ]. Nurses mentioned that this device had a short battery life and poor connection but it reported better insight into the vital signs [ 59 ].…”

Section: Resultsmentioning

confidence: 99%

“…Besides, physicians were positive about the potential of continuous monitoring, as this device provided reassurance to patients and supported interdisciplinary communication between nurses and physicians [ 39 ]. Another study stated that 67% of the nurses were positive about the deployment of continuous monitoring in the ward [ 51 ]. All nurses were positive that the monitor provided valuable patient data that increased patient safety [ 60 ].…”

Section: Resultsmentioning

confidence: 99%

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Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review

Leenen¹,

Leerentveld²,

Dijk³

et al. 2020

J Med Internet Res

139

128

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Background Continuous monitoring of vital signs by using wearable wireless devices may allow for timely detection of clinical deterioration in patients in general wards in comparison to detection by standard intermittent vital signs measurements. A large number of studies on many different wearable devices have been reported in recent years, but a systematic review is not yet available to date. Objective The aim of this study was to provide a systematic review for health care professionals regarding the current evidence about the validation, feasibility, clinical outcomes, and costs of wearable wireless devices for continuous monitoring of vital signs. Methods A systematic and comprehensive search was performed using PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from January 2009 to September 2019 for studies that evaluated wearable wireless devices for continuous monitoring of vital signs in adults. Outcomes were structured by validation, feasibility, clinical outcomes, and costs. Risk of bias was determined by using the Mixed Methods Appraisal Tool, quality assessment of diagnostic accuracy studies 2nd edition, or quality of health economic studies tool. Results In this review, 27 studies evaluating 13 different wearable wireless devices were included. These studies predominantly evaluated the validation or the feasibility outcomes of these devices. Only a few studies reported the clinical outcomes with these devices and they did not report a significantly better clinical outcome than the standard tools used for measuring vital signs. Cost outcomes were not reported in any study. The quality of the included studies was predominantly rated as low or moderate. Conclusions Wearable wireless continuous monitoring devices are mostly still in the clinical validation and feasibility testing phases. To date, there are no high quality large well-controlled studies of wearable wireless devices available that show a significant clinical benefit or cost-effectiveness. Such studies are needed to help health care professionals and administrators in their decision making regarding implementation of these devices on a large scale in clinical practice or in-home monitoring.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review

Leenen¹,

Leerentveld²,

Dijk³

et al. 2020

J Med Internet Res

139

128

View full text Add to dashboard Cite

show abstract

“…[44][45][46][47][48] Monitoring devices used were specified except in Cavallini et al 46 Vital signs monitored were specified in all except Pearl et al 49 All studies in this group only included nonacute and non-high-risk patients from general medical or surgical wards. 29,[44][45][46][47][48][49][50][51] Association with clinical parameters All five studies in Group A demonstrated clinically relevant information can be derived from data obtained through multi-parameter CoNiM. There were three main themes: patient information; predictive information; and diagnostic information.…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…Mortality. There was reduced mortality in patients with CoNiM in five studies 29,45,46,49,51 except Langhorne et al 47 Langhorne et al 47 included 'early mobilisation' as a separate intervention; therefore, half of the control population and half of the CoNiM population were also enrolled in 'early mobilisation'. The heterogenous population compounded by a small sample size (n ¼ 32) may have skewed the results.…”

Section: Impact On Clinical Outcomementioning

confidence: 99%

Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: a systematic review and meta-analysis

et al. 2020

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Objective Delayed response to clinical deterioration as a result of intermittent vital sign monitoring is a cause of preventable morbidity and mortality. This review focuses on the clinical impact of multi-parameter continuous non-invasive monitoring of vital signs (CoNiM) in non-intensive care unit patients. Design Systematic review and meta-analysis of primary studies. Embase, MEDLINE, HMIC, PsycINFO and Cochrane were searched from April 1964 to 18 June 2019 with no language restriction. Setting The search was limited to hospitalised, non-intensive care unit adult patients who had two or more vital signs continuously monitored. Participants All primary studies that evaluated the clinical impact of using multi-parameter CoNiM in adult hospital wards outside of the intensive care unit. Main outcome measures Clinical impact of multi-parameter CoNiM. Results This systematic review identified 14 relevant studies from 3846 search results. Five studies were classified as Group A – associations found between measured vital signs and clinical parameters. Nine studies were classified as Group B – comparison between clinical outcomes of patients with and without multi-parameter CoNiM. Vital signs data from CoNiM were found to associate with type of presenting complaint, level of renal function and incidence of major clinical events. CoNiM also assisted in diagnosis by differentiating between patients with acute heart failure, stroke and sepsis (with sub-clustering of septic patients). In the meta-analysis, patients on multi-parameter CoNiM had a 39% decrease in risk of mortality (risk ratio [RR] 0.61; 95% confidence interval [95% CI] 0.39, 0.95) when compared to patients with regular intermittent monitoring. There was a trend of reduced intensive care unit transfer (RR 0.86; 95% CI 0.67, 1.11) and reduced rapid response team activation (RR 0.61; 95% CI 0.26–1.43). A trend towards reduced hospital length of stay was also found using weighted mean difference (WMD –3.32 days; 95% CI -8.82–2.19 days). Conclusion There is evidence of clinical benefit in implementing CoNiM in non-intensive care unit patients. This review supports the use of multi-parameter CoNiM outside of intensive care unit with further large-scale RCTs required to further affirm clinical impact.

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The Nurse’s View: Stakeholders, Challenges, and Innovation During COVID-19 Pandemic

Hudson

2022

Health Informatics

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Using Continuous Vital Sign Monitoring to Detect Early Deterioration in Adult Postoperative Inpatients

Abstract: cVSM demonstrated detection of early signs of patient deterioration to prevent FTR.

Cited by 38 publications

References 10 publications

Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review

Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review

Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: a systematic review and meta-analysis

The Nurse’s View: Stakeholders, Challenges, and Innovation During COVID-19 Pandemic

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