Evaluation of a wireless, portable, wearable multi-parameter vital signs monitor in hospitalized neurological and neurosurgical patients

J Clin Monit Comput. 2018 Oct;32(5):945-951. doi: 10.1007/s10877-017-0085-0. Epub 2017 Dec 6.

Abstract

Unrecognized changes in patients' vital signs can result in preventable deaths in hospitalized patients. Few publications or studies instituting routine patient monitoring have described implementation and the setting of alarm parameters for vital signs. We wanted to determine if continuous multi-parameter patient monitoring can be accomplished with an alarm rate that is acceptable to hospital floor nurses and to compare the rate of patient deterioration events to those observed with routine vital sign monitoring. We conducted a prospective, observational, 5-month pilot study in a 26-bed adult, neurological/neurosurgical unit (non-ICU) in an academic medical center. A patient surveillance system employing a wireless body-worn vital signs monitor with automated nursing notification of alarms via smartphones was used to gather data. Data collected included: alarm rates, rapid response team (RRT) calls, intensive care unit (ICU) transfers, and unplanned deaths before and during the pilot study. Average alarm rate for all alarms (SpO2, HR, RR, NIBP) was 2.3 alarms/patient/day. The RRT call rate was significantly reduced (p < 0.05) from 189 to 158 per 1000 discharges. ICU transfers per 1000 discharges were insignificantly reduced from 53 to 40 compared to the previous 5-month period in the same unit. Similar measures of comparison units did not change over the same period. Although unplanned patient deaths in the study unit were also reduced during the intervention period, this was not statistically significant. Continual, multi-parameter vital signs monitoring can be customized to reduce a high alarm rates, and may reduce rapid response team calls.

Keywords: Critical care; Deterioration; Early warning score; Electronic health records; Patient safety; Physiologic monitoring.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Clinical Alarms / statistics & numerical data
  • Humans
  • Monitoring, Physiologic / instrumentation*
  • Monitoring, Physiologic / nursing
  • Monitoring, Physiologic / statistics & numerical data
  • Neurophysiological Monitoring / instrumentation*
  • Neurophysiological Monitoring / nursing
  • Neurophysiological Monitoring / statistics & numerical data
  • Neuroscience Nursing
  • Neurosurgical Procedures / nursing
  • Pilot Projects
  • Prospective Studies
  • Vital Signs / physiology*
  • Wearable Electronic Devices* / statistics & numerical data