Article Text
Abstract
Objective To determine feasibility, in terms of acceptability and system fidelity, of continuous vital signs monitoring in abdominal surgery patients on a general ward.
Design Observational cohort study.
Setting Tertiary teaching hospital.
Participants Postoperative abdominal surgical patients (n=30) and nurses (n=23).
Interventions Patients 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.
Outcomes System fidelity was measured by analysis of the monitoring data. Acceptability by patients and nurses was assessed using questionnaires.
Results Thirty 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.
Conclusions Continuous 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.
- surgery
- health & safety
- adverse events
- pancreatic surgery
- hepatobiliary surgery
- colorectal surgery
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Footnotes
Contributors JPLL conceived of the presented idea. JPLL, EMD, JDvD, HLvW, GAP: conception or design of the work. JPLL: data collection. JPLL, EMD: data analysis and interpretation. JPLL, EMD, JDvD, HLvW, CK, LS, GAP: drafting the article. JPLL, EMD, JDvD, HLvW, CK, LS, GAP: critical revision of the article. All authors: final approval of the version to be published.
Funding This work was supported by Isala Innovation and Science Fund (grant number INNO1915) and Zilveren Kruis (grant number E/190011).
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The Medical Ethics Review Committee of Isala waived the need for ethical approval (protocol no 190606). The study was conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained from each patient to participate in the study.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement No data are available.
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