Abstract
Venous needle dislodgement (VND) is a major healthcare safety concern in patients undergoing hemodialysis. Although VND is uncommon, it can be life-threatening. The main objective of this study was to implement a real-time multi-bed monitoring system for VND by combining a novel leakage-detection device and IoMT (Internet of Medical Things) technology. The core of the system, the Acusense IoMT platform, consisted of a novel leakage-detection patch comprised of multiple concentric rings to detect blood leakage and quantify the leaked volume. The performance of the leakage-detection system was evaluated on a prosthetic arm and clinical study. Patients with a high risk of blood leakage were recruited as candidates. The system was set up in a hospital, and the subjects were monitored for 2 months. During the pre-clinical simulation experiment, the system could detect blood leakage volumes from 0.3 to 0.9 mL. During the test of the IoMT system, the overall success rate of tests was 100%, with no lost data packets. A total of 701 dialysis sessions were analyzed, and the accuracy and sensitivity were 99.7% and 90.9%, respectively. Evaluation questionnaires showed that the use of the system after training changed attitudes and reduced worry of the nursing staff. Our results show the feasibility of using a novel detector combined with an IoMT system to automatically monitor multi-bed blood leakage. The innovative concentric-circle design could more precisely control the warning blood-leakage threshold in any direction to achieve clinical cost-effectiveness. The system reduced the load on medical staff and improved patient safety. In the future, it could also be applied to home hemodialysis for telemedicine during the era of COVID-19.
Highlights
In 2019, the World Health Assembly (WHA) declared that patient safety is a critical challenge for public health worldwide
The sensor patch was incorporated into a flexible support board and can detect fluid leakage in the range of 0.5 to 1 mL without false warnings from micro-leaks. Their cross-loop circuit sensing is based on multi-channel mapping. This device was tested at a medical center during 544 sessions of hemodialysis, and the results showed that the precision and accuracy of detection were 98.7% and 98.9%, respectively
The results showed theinmeasured voltages were 2.12 ± 0.09, events of venous needle dislodgement bleeding during dialysis noted by A, B, C, D and
Summary
In 2019, the World Health Assembly (WHA) declared that patient safety is a critical challenge for public health worldwide. Minor and critical blood leakage incurs 818 million dollars in terms of medical cost each year in the United States [4]. In 2012, the American Nephrology Nurses’ Association set up a team to examine the occurrence, consequences, and practices related to VND in an attempt to help kidney disease paramedics, patients, and families formulate countermeasures. According to their survey, (1) more than 70% of respondents said that VND was common in those undergoing chronic hemodialysis, (2) 76.6% of respondents said that they had experienced
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