M. Weenk1, S. Bredie2, L. Engelen3, T. Van De Belt3, H. Van Goor1 1Radboudumc,Surgery,Nijmegen, GELDERLAND, Netherlands 2Radboudumc,Internal Medicine,Nijmegen, GELDERLAND, Netherlands 3Radboudumc,Radboud REshape Innovation Center,Nijmegen, GELDERLAND, Netherlands
Introduction: Measurement 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 measured three to four times a day and may not capture early deterioration. A delay in diagnosing deterioration is associated with increased mortality and costs. Clinical deterioration might be detected earlier by wearable devices continuously monitoring vital signs, which allows clinicians to take corrective interventions. Further these devices potentially reduce patient discomfort and work load of nurses. In this pilot study, reliability of continuous monitoring using the ViSi Mobile (VM; Sotera; HR, RR, saturation, BP, skin temperature) and HealthPatch (HP; Vital Connect; HR, RR, skin temperature) was tested and experiences of patients and nurses were collected.
Methods: Twenty patients, 10 at the surgical and 10 at the internal medicine ward, were monitored with both devices simultaneously for 2-3 days and data were compared with MEWS measurements taken as reference method. Artifacts in continuous data were registered and analyzed. Patient and nurse experiences were obtained by semi-structured interviews.
Results: Eighty-six MEWS measurements were compared with VM and HP measurements. Almost all VM vital signs (mean difference HR -0.09 bpm; RR 1.00 breaths/min; saturation 0.19%; temperature 0.00 ?C; BP systolic 1.33 mmHg) and all HP vital signs (HR -2.10 bpm; RR -0.58 breaths/min; temperature 0.00 ?C) were in range of accepted discrepancies, although wide limits of agreement were found. The largest discrepancy in mean difference was found for VM diastolic blood pressure (-8.33 mmHg) probably due to inaccuracy of measurement by nurses. Predominant VM artifact (70%) was a connection failure. Over 50% of all HP artifacts had unknown cause, were self limiting and took less than one hour. The majority of patients, family members, and nurses were positive about VM and HP, e.g. increased feelings of safety, better sleep and more comfort for patient and nurses. Devices did not restrict patients’ daily activities. Disadvantage were the cables (showering) and the short battery life of the VM device.
Conclusion: Both VM and HP have potential for continuously measuring vital signs in hospitalized patients. The devices were well received and comfortable for most patients. A further study focuses on the different effects of VM or HP compared to routine MEWS on patient comfort and safety and nurse workload, and on early detection of deterioration.
