Impact of wearable wireless continuous vital sign monitoring in abdominal surgical patients: before-after study.

Autor:	Leenen JPL; Department of Surgery, Isala, Zwolle, The Netherlands.; Connected Care Centre, Isala, Zwolle, The Netherlands.; Research Group IT Innovations in Healthcare, Windesheim University of Applied Sciences, Zwolle, The Netherlands., Ardesch V; Flex pool department, Isala, Zwolle, The Netherlands., Kalkman CJ; Department of Anaesthesiology, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands., Schoonhoven L; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.; School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK., Patijn GA; Department of Surgery, Isala, Zwolle, The Netherlands.; Connected Care Centre, Isala, Zwolle, The Netherlands.
Jazyk:	angličtina
Zdroj:	BJS open [BJS Open] 2024 Jan 03; Vol. 8 (1).
DOI:	10.1093/bjsopen/zrad128
Abstrakt:	Background: Technological advances have enabled continuous monitoring of vital signs (CMVS) by wearable, wireless devices on general hospital wards to facilitate early detection of clinical deterioration, which could potentially improve clinical outcomes. However, evidence on the impact of these CMVS systems on patient outcomes is limited. This research aimed to explore the effect of CMVS on the clinical outcomes in major abdominal surgery patients in a general surgery ward. Methods: A single-centre before-after study was conducted from October 2019 to June 2022. Patients in the intervention group received CMVS in addition to conventional intermittent vital sign monitoring (standard care for control group). With CMVS, heart rate and respiratory rate were measured every 5 min by a patch sensor. Proactive vital signs trends assessments and, when necessary, subsequent nursing activities were performed every nursing shift. The primary outcome of interest was the length of hospital stay (LOS); also, 12 patient-related outcomes were analysed. In the CMVS group, follow-up nursing activities of deviating vital signs trends were described and patient acceptability was measured. Post-hoc subgroup analysis was performed for colorectal and hepatopancreatobiliary surgery. Results: A total of 908 patients were included (colorectal: n = 650; hepatopancreatobiliary: n = 257). Overall, median LOS was lower in the CMVS group (5.0 versus 5.5 days; P = 0.012), respectively. Post-hoc subgroup analysis showed this reduction in LOS was mostly observed in the colorectal group and not in the hepatopancreatobiliary group. Apart from a decrease in nurse-to-house-officer calls (from 15.3% to 7.7%; P = 0.007), all secondary clinical outcomes were similar in CMVS and control groups. However, a non-significant trend towards less-severe complications and reduced ICU LOS was observed in the CMVS group. In CMVS patients, 109 additional nursing activities were performed and 83% of patients indicated CMVS was acceptable. Conclusion: CMVS was associated with a significant reduction in LOS, while other clinical outcomes were unchanged. CMVS triggered additional nursing activities such as extra patient assessments and therapeutic interventions. (© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.)
Databáze:	MEDLINE
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