Usefulness of a mobile phone application for respiratory rate measurement in adult patients

Abstract

Aims: Respiratory rate measurement is one of the core nursing skills for early detection of deterioration of a patient's condition. Nevertheless, it is sometimes bothersome to visually measure respiratory rate over 1 min. Respiratory rate measurement using a mobile phone application "RRate" has been reported to be accurate and completed in a short time. However, it has only been investigated in children. The aim of this study was to validate the "RRate" compared with the 1-min method in adult patients.Methods: This was a cross-sectional study in the setting of a nursing school. Videos of the movement of the thorax during respiration of adult patients were made. Nursing students watched these videos and measured respiratory rate with each method. Bland-Altman analysis was used to calculate bias and limits of agreement. The times taken for the measurements were compared using a t test. Results: A total of 59 nursing students participated. When compared to the reference measurement, the one measured using "RRate" and the one measured over 1 min showed a bias of 0.40 breaths per minute and 0.65 breaths per minute, limits of agreement of À2.86 to 3.67 breaths per minute and À2.11 to 3.41 breaths per minute, respectively. The mean measurement time for "RRate" was 22.8 s (95% CI 13.9-36.6), which was significantly shorter than the 65.8 s (95% CI 61.0-73.2) for the measurement over 1 min (p < .001). Conclusions: Respiratory rate can be measured accurately in a shorter time using a mobile phone application in adult patients. K E Y W O R D S adult, mobile phone application, respiratory rate, vital sign 1 | INTRODUCTION Abnormalities in respiratory rate (RR) are an early indicator of acute deterioration of a patient's condition (Churpek et al., 2012). While good collaboration and communication between nurses and doctors are essential in the management of deteriorating patients (Petersen et al., 2017), nurses play a major role in identifying unwell patients. Thus, RR measurement is regarded as one of the core nursing skills (Rolfe, 2019). Despite its

Performance and usability of a new mobile application for measuring respiratory rate in young children with acute lower respiratory infections

“…Participants obtained a RR in 30 s in 360 of 390 (92%) attempts when using ALRITE. The median (IQR) number of taps required to obtain an RR with ALRITE was 27 (23)(24)(25)(26)(27)(28)(29)(30)(31)(32). RRate required far fewer taps to obtain an RR, with a median of 6 (4-8).…”

“…The reference standard (true RR) was determined by two experienced clinicians (Rebecca Spurr and Laura E. Ellington) through manual count for 60 s. Manual counting was chosen as this is the most commonly used reference tool in other validation studies of existing RR assessment aids. 3,18,19,23 Before recording any data, the observers completed several measurements together to standardize the procedure and ensure they were obtaining the same RR. For each video, both clinicians measured twice independently and repeated a third time if there was a discrepancy.…”

How to facilitate respiratory rate measurement in the emergency room

“…They calculated bias and limits of agreement using Bland-Altman analysis to see if the measurements using a mobile phone application matched the 60-s measurements. The mean measurement time was 22.8 s (95% CI 13.9-36.6) with a high agreement rate, indicating that a mobile phone application could be used to accurately measure respiratory rate in adult patients in a shorter time (Suzuki et al, 2022). This method is expected to make it possible to obtain an accurate respiratory rate in a short time, even in the emergency room.…”

Society of Critical Care Medicine Guidelines on Recognizing and Responding to Clinical Deterioration Outside the ICU: 2023

“…However, numerous studies demonstrate incomplete and/or incorrect vital sign measurement is common in hospitalized patients (7, 8) leading to failure to detect or recognize key signs of deterioration. We also noted the importance of education (9), audits (7), and feedback to encourage improvement (10, 11) and compliance (9) with proper measurement techniques, accurate documentation, and prompt response to significant physiologic abnormalities.…”