Vital signs monitoring on general wards: clinical staff perceptions of current practices and the planned introduction of continuous monitoring technology

Abstract

While continuous monitoring devices were seen as a potentially positive tool to support the identification of patient deterioration, drawbacks, such as the potential for reduced patient contact, revealed key areas that will require close surveillance following the implementation of devices. Training and improved interdisciplinary communication were identified as key requisites for successful implementation.

Effect of an automated notification system for deteriorating ward patients on clinical outcomes

“…Nursing teams were appreciative of the technology used. We are aware that especially with regards to continuous monitoring these finding might not be generalizable [27, 28]. …”

The impact of continuous versus intermittent vital signs monitoring in hospitals: A systematic review and narrative synthesis

“…Five studies reported nursing perception (Banks et al, 1999;Jeskey et al, 2011;Langhorne et al, 2010;Prgomet et al, 2016;Watkins et al, 2015) and all identified similar themes.…”

“…Nurses perceived that greater 'availability and accessibility' of vital signs information would support their decisionmaking and provide reassurance to patients. (Prgomet et al, 2016) The value of continuous monitoring was particularly evident to nurses who were trained and felt confident in its use, (Jeskey et al, 2011;Langhorne et al, 2010) while lack of familiarity with the technology was associated with loss of engagement and the perception of increased workload. (Banks et al, 1999) Banks et al stress the importance of training in time allocated away from clinical duties.…”

“…(Jeskey et al, 2011) Prgomet et al reported concerns from both doctors and nurses about over-reliance on continuous monitoring leading to decreased bedside interactions. (Prgomet et al, 2016) Some nurses were worried that visibility of information and alarms would cause patient anxiety, leading to increased time spent to reassure them. Continuous monitoring devices were also considered to provide opportunities for increased engagement of patients in their own care.…”

“…(Jeskey et al, 2011) There was also concern that doctors might become overburdened and desensitised to calls. (Prgomet et al, 2016) Three studies have aimed to quantify alert burden. Average number of alerts per patient per day varies from 7(Voepellewis et al, 2013) to 10.8 (Watkins et al, 2015) to 95.6.…”