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A pilot study to investigate real-time digital alerting from wearable sensors in surgical patients
BACKGROUND: Continuous vital sign monitoring may identify changes sooner than current standard monitoring. OBJECTIVE: To investigate if the use of real-time digital alerts sent to healthcare staff can improve the time taken to identify unwell patients and those with sepsis. DESIGN: A prospective coh...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9258087/ https://www.ncbi.nlm.nih.gov/pubmed/35794669 http://dx.doi.org/10.1186/s40814-022-01084-2 |
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author | Joshi, Meera Ashrafian, Hutan Arora, Sonal Sharabiani, Mansour McAndrew, Kenny Khan, Sadia N. Cooke, Graham S. Darzi, Ara |
author_facet | Joshi, Meera Ashrafian, Hutan Arora, Sonal Sharabiani, Mansour McAndrew, Kenny Khan, Sadia N. Cooke, Graham S. Darzi, Ara |
author_sort | Joshi, Meera |
collection | PubMed |
description | BACKGROUND: Continuous vital sign monitoring may identify changes sooner than current standard monitoring. OBJECTIVE: To investigate if the use of real-time digital alerts sent to healthcare staff can improve the time taken to identify unwell patients and those with sepsis. DESIGN: A prospective cohort study design. SETTING: West Middlesex University Hospital, UK. PARTICIPANTS: Fifty acutely unwell surgical patients admitted to hospital. INTERVENTION: Patients wore a lightweight wearable sensor measuring heart rate (HR), respiratory rate (RR) and temperature every 2 min whilst standard intermittent ward monitoring of vital signs was performed by nurses. Digital alerts were sent to healthcare staff from the sensor to a smartphone device. All alerts were reviewed for recruited patients to identify the exact time on the sensor in which deterioration occurred. The time to acknowledgement was then reviewed for each action and an average time to acknowledgement calculated. RESULTS: There were 50 patients recruited in the pilot study, of which there were vital sign alerts in 18 patients (36%). The total number of vital sign alerts generated in these 18 patients was 51. Of these 51 alerts, there were 7 alerts for high HR (13.7%), 33 for RR (64.7%) and 11 for temperature (21.6%). Out of the 27 acknowledged alerts, there were 2 alerts for HR, 17 for RR and 8 for temperature. The average time to staff acknowledgement of the notification for all alerts was 154 min (2.6 h). There were some patients which had shown signs of deterioration in the cohort. The frequency of routine observation monitoring was increased in 2 cases, 3 patients were referred to a senior clinician and 2 patients were initiated on the sepsis pathway. CONCLUSION: This study demonstrates the evaluation of digital alerts to nurses in real time. Although not all alerts were acknowledged, deterioration on the ward observations was detected and actions were taken accordingly. Patients were started on the sepsis pathway and escalation to senior clinicians occurred. Further research is required to review why only some alerts were acknowledged and the effects of digital alerting on patient outcomes. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04638738 |
format | Online Article Text |
id | pubmed-9258087 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-92580872022-07-07 A pilot study to investigate real-time digital alerting from wearable sensors in surgical patients Joshi, Meera Ashrafian, Hutan Arora, Sonal Sharabiani, Mansour McAndrew, Kenny Khan, Sadia N. Cooke, Graham S. Darzi, Ara Pilot Feasibility Stud Research BACKGROUND: Continuous vital sign monitoring may identify changes sooner than current standard monitoring. OBJECTIVE: To investigate if the use of real-time digital alerts sent to healthcare staff can improve the time taken to identify unwell patients and those with sepsis. DESIGN: A prospective cohort study design. SETTING: West Middlesex University Hospital, UK. PARTICIPANTS: Fifty acutely unwell surgical patients admitted to hospital. INTERVENTION: Patients wore a lightweight wearable sensor measuring heart rate (HR), respiratory rate (RR) and temperature every 2 min whilst standard intermittent ward monitoring of vital signs was performed by nurses. Digital alerts were sent to healthcare staff from the sensor to a smartphone device. All alerts were reviewed for recruited patients to identify the exact time on the sensor in which deterioration occurred. The time to acknowledgement was then reviewed for each action and an average time to acknowledgement calculated. RESULTS: There were 50 patients recruited in the pilot study, of which there were vital sign alerts in 18 patients (36%). The total number of vital sign alerts generated in these 18 patients was 51. Of these 51 alerts, there were 7 alerts for high HR (13.7%), 33 for RR (64.7%) and 11 for temperature (21.6%). Out of the 27 acknowledged alerts, there were 2 alerts for HR, 17 for RR and 8 for temperature. The average time to staff acknowledgement of the notification for all alerts was 154 min (2.6 h). There were some patients which had shown signs of deterioration in the cohort. The frequency of routine observation monitoring was increased in 2 cases, 3 patients were referred to a senior clinician and 2 patients were initiated on the sepsis pathway. CONCLUSION: This study demonstrates the evaluation of digital alerts to nurses in real time. Although not all alerts were acknowledged, deterioration on the ward observations was detected and actions were taken accordingly. Patients were started on the sepsis pathway and escalation to senior clinicians occurred. Further research is required to review why only some alerts were acknowledged and the effects of digital alerting on patient outcomes. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04638738 BioMed Central 2022-07-06 /pmc/articles/PMC9258087/ /pubmed/35794669 http://dx.doi.org/10.1186/s40814-022-01084-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Joshi, Meera Ashrafian, Hutan Arora, Sonal Sharabiani, Mansour McAndrew, Kenny Khan, Sadia N. Cooke, Graham S. Darzi, Ara A pilot study to investigate real-time digital alerting from wearable sensors in surgical patients |
title | A pilot study to investigate real-time digital alerting from wearable sensors in surgical patients |
title_full | A pilot study to investigate real-time digital alerting from wearable sensors in surgical patients |
title_fullStr | A pilot study to investigate real-time digital alerting from wearable sensors in surgical patients |
title_full_unstemmed | A pilot study to investigate real-time digital alerting from wearable sensors in surgical patients |
title_short | A pilot study to investigate real-time digital alerting from wearable sensors in surgical patients |
title_sort | pilot study to investigate real-time digital alerting from wearable sensors in surgical patients |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9258087/ https://www.ncbi.nlm.nih.gov/pubmed/35794669 http://dx.doi.org/10.1186/s40814-022-01084-2 |
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