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Jobbe P L Leenen, Eline M Dijkman, Joris D van Dijk, Henderik L van Westreenen, Cor Kalkman, Lisette Schoonhoven, Gijsbert A Patijn, BMJ Open 2021
 

Summary

Background
The postoperative complication rate after major abdominal surgery is 20%–44%, which may result in reinterventions, prolonged hospital stay, intensive care unit (ICU) admissions and mortality, and eventually to lower life expectancy, lower quality of life and higher costs. Early detection of postoperative clinical deterioration on the ward may allow for early intervention and better outcomes. Emerging evidence shows that [wearable, wireless] monitoring sensors are accurate, may improve outcomes and reduce costs by allowing earlier detection of changes in vital signs in clinical practice.

Objective
The aim of the study was to determine the feasibility, in terms of acceptability and system fidelity, of continuous vital signs monitoring with the Sensium system, among abdominal surgery patients on a general surgery ward.


Methods
An observational cohort study was conducted for a 3-month period on one surgical ward of a large tertiary teaching hospital. 
Adult patients scheduled for elective colorectal or pancreatic resection were recruited through convenience sampling. In addition to standard care, patients included in the study were continuously monitored by the Sensium system.

Results
Thirty patients were monitored for a median duration hirty patients were monitored for a median duration of 81 hours. In terms of patient acceptability, twenty-seven patients returned the questionnaire. Of these, 25 patients (93%) rated wearing the patch as comfortable. Additionally, 18 patients (67%) agreed they felt safer during hospitalisation, and 8 patients (30%) were neutral about this statement. For a future admission in the hospital, 24 patients (89%) would like to wear it and 20 patients (80%) would be willing to wear the patch for postsurgical home monitoring. Patients stated that “‘It provided a safe feeling for family also,” and “I knew my limits through the system.”

23 nurses returned the nurse questionnaire. Nurse satisfaction overall was mixed and 60.9% responded positive or neutral. 

The system was found to be easily used and picked up. Out of the 23 nurses, 15 (65%) agreed they easily remembered how to use it and quickly became skilful with it (65%). The nurses perceived the ease of use favourably, for instance regarding the statement ‘It is simple to use (73.5% positive response) and ‘It is easy to use’ (73.9% positive response). 

Conclusion:
Continuous monitoring of vital signs with a wearable device was very well accepted by patients. Nurses’ ratings were highly variable, resulting in on average neutral attitude towards remote monitoring. The results suggest it is feasible to monitor vital signs continuously on general wards.


Link:
https://bmjopen.bmj.com/content/11/2/e042735


Status:

Open Access.

© Author(s) (or their employer(s) 2021.

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