Experiences of current vital signs monitoring practices and views of wearable monitoring: A qualitative study in patients and nurses

Areia, Carlos; King, Elizabeth A.; Ede, Jody; Young, Louise; Tarassenko, Lionel; Watkinson, Peter; Vollam, Sarah

doi:10.1111/jan.15055

Cited by 31 publications

(24 citation statements)

References 43 publications

(63 reference statements)

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“…Current sensors and vital sign trends still do not include factors such as the nurse worry factor and the critical EWS component ‘level of consciousness’ [ 32 – 34 ]. In line with other studies, the value of the nurse’s clinical observations in detection of deterioration was also with respect to reservations about a potential decrease in the bedside nurse-patient contacts by using CMVS which may limit the value of their clinical judgement [ 15 , 35 , 36 ].…”

Section: Discussionsupporting

confidence: 73%

“…Although, we found that smooth integration in IT systems and clinical workflows as well as selective alarm management are important factors to support successful CMVS implementation. Specifically, this includes the need for CMVS data integration into the EMR and in mobile devices and an adequate connectivity and range of the sensor, which was also mentioned in previous studies [ 11 , 36 ]. Also, integration in clinical workflows should be optimized.…”

Section: Discussionmentioning

confidence: 99%

“…Considering Motivation, nurses seem to be clearly motivated to use this innovation because they believe in the potential for improving the quality and safety of patient care. The potential benefit for patients was also recognized by nurses in several other studies with a CMVS systems, specifically for earlier detection of clinical deterioration in certain high risk patient groups and providing remote insight in the patients vital signs during night shifts [ 14 , 31 , 32 , 36 ]. Unfortunately, contrary to common belief among nurses strong evidence for clinical benefit and cost-effectiveness is still lacking due to the various study designs, low study quality and various outcome measures used in available published reports [ 11 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

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Nurses’ experiences with continuous vital sign monitoring on the general surgical ward: a qualitative study based on the Behaviour Change Wheel

et al. 2022

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Background To support early recognition of clinical deterioration on a general ward continuous vital signs monitoring (CMVS) systems using wearable devices are increasingly being investigated. Although nurses play a crucial role in successful implementation, reported nurse adoption and acceptance scores vary significantly. In-depth insight into the perspectives of nurses regarding CMVS is lacking. To this end, we applied a theoretical approach for behaviour change derived from the Behaviour Change Wheel (BCW). Aim To provide insight in the capability, opportunity and motivation of nurses working with CMVS, in order to inform future implementation efforts. Methods A qualitative study was conducted, including twelve nurses of a surgical ward in a tertiary teaching hospital with previous experience of working with CMVS. Semi-structured interviews were audiotaped, transcribed verbatim, and analysed using thematic analysis. The results were mapped onto the Capability, Opportunity, Motivation – Behaviour (COM-B) model of the BCW. Results Five key themes emerged. The theme ‘Learning and coaching on the job’ linked to Capability. Nurses favoured learning about CVSM by dealing with it in daily practice. Receiving bedside guidance and coaching was perceived as important. The theme ‘interpretation of vital sign trends’ also linked to Capability. Nurses mentioned the novelty of monitoring vital sign trends of patients on wards. The theme ‘Management of alarms’ linked to Opportunity. Nurses perceived the (false) alarms generated by the system as excessive resulting in feelings of irritation and uncertainty. The theme ‘Integration and compatibility with clinical workflow’ linked to Opportunity. CVSM was experienced as helpful and easy to use, although integration in mobile devices and the EMR was highly favoured and the management of clinical workflows would need improvement. The theme ‘Added value for nursing care’ linked to Motivation. All nurses recognized the potential added value of CVSM for postoperative care. Conclusion Our findings suggest all parts of the COM-B model should be considered when implementing CVSM on general wards. When the themes in Capability and Opportunity are not properly addressed by selecting interventions and policy categories, this may negatively influence the Motivation and may compromise successful implementation.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Nurses’ experiences with continuous vital sign monitoring on the general surgical ward: a qualitative study based on the Behaviour Change Wheel

et al. 2022

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“…Several studies reported a patient preference to go home with wearable monitoring 55 , potentially facilitating earlier discharge from the hospital 38 . Patients emphasized the importance of not losing opportunities for human contact with clinical staff, and concerns about devices not capturing other important aspects of the patient experience such as pain 33 , 54 , 56 , 57 .…”

Section: Resultsmentioning

confidence: 99%

“…Nurses and other clinicians often recognized the potential of wearable devices for continuous vital signs monitoring, but also expressed concerns regarding the number of false-positive alerts (when the wearable device triggered an alert for abnormal vital signs that were normal on manual review of the patient), increasing workload, and overload of data 33 , 55 , 57 .…”

Section: Resultsmentioning

confidence: 99%

Wearable devices to monitor recovery after abdominal surgery: scoping review

Wells

Penfold

et al. 2022

BJS Open

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Background Wearable devices have been proposed as a novel method for monitoring patients after surgery to track recovery, identify complications early, and improve surgical safety. Previous studies have used a heterogeneous range of devices, methods, and analyses. This review aimed to examine current methods and wearable devices used for monitoring after abdominal surgery and identify knowledge gaps requiring further investigation. Methods A scoping review was conducted given the heterogeneous nature of the evidence. MEDLINE, EMBASE, and Scopus databases were systematically searched. Studies of wearable devices for monitoring of adult patients within 30 days after abdominal surgery were eligible for inclusion. Results A total of 78 articles from 65 study cohorts, with 5153 patients were included. Thirty-one different wearable devices were used to measure vital signs, physiological measurements, or physical activity. The duration of postoperative wearable device use ranged from 15 h to 3 months after surgery. Studies mostly focused on physical activity metrics (71.8 per cent). Continuous vital sign measurement and physical activity tracking both showed promise for detecting postoperative complications earlier than usual care, but conclusions were limited by poor device precision, adherence, occurrence of false alarms, data transmission problems, and retrospective data analysis. Devices were generally well accepted by patients, with high levels of acceptance, comfort, and safety. Conclusion Wearable technology has not yet realized its potential to improve postoperative monitoring. Further work is needed to overcome technical limitations, improve precision, and reduce false alarms. Prospective assessment of efficacy, using an intention-to-treat approach should be the focus of further studies.

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HeartView: An Extensible, Open-Source, Web-Based Signal Quality Assessment Pipeline for Ambulatory Cardiovascular Data

Yamane,

Mishra,

Goodwin

2024

Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering

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Experiences of current vital signs monitoring practices and views of wearable monitoring: A qualitative study in patients and nurses

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 31 publications

References 43 publications

Nurses’ experiences with continuous vital sign monitoring on the general surgical ward: a qualitative study based on the Behaviour Change Wheel

Nurses’ experiences with continuous vital sign monitoring on the general surgical ward: a qualitative study based on the Behaviour Change Wheel

Wearable devices to monitor recovery after abdominal surgery: scoping review

HeartView: An Extensible, Open-Source, Web-Based Signal Quality Assessment Pipeline for Ambulatory Cardiovascular Data

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