Abstract

BackgroundMeasurement of vital signs in hospitalized patients is necessary to assess the clinical situation of the patient. Early warning scores (EWS), such as the modified early warning score (MEWS), are generally calculated 3 times a day, but these may not capture early deterioration. A delay in diagnosing deterioration is associated with increased mortality. Continuous monitoring with wearable devices might detect clinical deterioration at an earlier stage, which allows clinicians to take corrective actions.ObjectiveIn this pilot study, the feasibility of continuous monitoring using the ViSi Mobile (VM; Sotera Wireless) and HealthPatch (HP; Vital Connect) was tested, and the experiences of patients and nurses were collected.MethodsIn this feasibility study, 20 patients at the internal medicine and surgical ward were monitored with VM and HP simultaneously for 2 to 3 days. Technical problems were analyzed. Vital sign measurements by nurses were taken as reference and compared with vital signs measured by both devices. Patient and nurse experiences were obtained by semistructured interviews.ResultsIn total, 86 out of 120 MEWS measurements were used for the analysis. Vital sign measurements by VM and HP were generally consistent with nurse measurements. In 15% (N=13) and 27% (N=23) of the VM and HP cases respectively, clinically relevant differences in MEWS were found based on inconsistent respiratory rate registrations. Connection failure was recognized as a predominant VM artifact (70%). Over 50% of all HP artifacts had an unknown cause, were self-limiting, and never took longer than 1 hour. The majority of patients, relatives, and nurses were positive about VM and HP.ConclusionsBoth VM and HP are promising for continuously monitoring vital signs in hospitalized patients, if the frequency and duration of artifacts are reduced. The devices were well received and comfortable for most patients.

Highlights

  • In hospitalized patients, vital signs are measured to assess the clinical situation of the patient and to identify clinical deterioration [1]

  • In 15% (N=13) and 27% (N=23) of the ViSi Mobile (VM) and HP cases respectively, clinically relevant differences in modified early warning score (MEWS) were found based on inconsistent respiratory rate registrations

  • Both VM and HP are promising for continuously monitoring vital signs in hospitalized patients, if the frequency and duration of artifacts are reduced

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Summary

Introduction

Vital signs are measured to assess the clinical situation of the patient and to identify clinical deterioration [1]. The EWS provides relevant data on patients’ health status, the interval measurements may not capture early deterioration of vital signs [17], during the night when clinical deterioration may remain undetected until the day [18]. This could explain why the majority of the unplanned ICU admissions take place between 8 am and 4 pm [19]. Continuous monitoring with wearable devices might detect clinical deterioration at an earlier stage, which allows clinicians to take corrective actions

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