Patients deteriorate

All hospitalised patients are at risk of deterioration but most catastrophic incidents are preceded by periods of change and abnormality in patients’ vital signs. If these changes in vital signs are detected and reacted to in a timely fashion then a significant proportion of costly patient deterioration can be avoided.

Currently approx. 10% of patients are harmed during their hospital stay and this represents a cost to the NHS of over £2.5B just to cover the additional length of stay for these patients.

Improved monitoring regimes & early detection of deterioration is key to reducing this significant burden for:

10% of patients harmed in UK hospitals5

The cost of extended length of stay to the NHS for patients harmed during their hospital stay.6

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Tachycardia (>100 bpm)

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Bradycardia (<60 bpm)

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Tachypnoea (>20 Br/m)

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Pyrexia (>37.5 °c)

A & E

Patient deteriorates while waiting for:
- Formal medical review.
- For further treatment or tests.
- For an in-patient bed.

General Medical

Emergency admissions – especially with potential instability.
Step down from ICU/Higher acuity areas.
Potential for patients to readmit to Critical Care.
Work closely with clinical outreach teams.

Post surgical

In-patient surgery - elective or emergency.
Complications after surgery:
- Haemorrhage
- Cardiovascular
- Infection/sepsis
- Respiratory depression

Elderly Care

Increased co-morbidities.
This patient group can deteriorate quickly.
Atypical presentation more likely.
Less likely to raise awareness of feeling unwell.

Neutropenic Patients

Cancer/Chemotherapy.
Autoimmune Diseases.
Drug regimes.
Patient group is more susceptible to infection.
More severe results.
Important to get antibiotics on board asap

Unmonitored patients

The 3 most serious, costly and avoidable care incidents in these areas are: Sepsis, Cardiac arrest, Respiratory depression

Sepsis is a life-threatening illness caused the body's response to an infection. Your immune system protects you from many illnesses and infections, but it’s also possible for it to go into overdrive in response to an infection.

Sepsis develops when the chemicals the immune system releases into the bloodstream to fight an infection cause inflammation throughout the entire body instead. Severe cases of sepsis can lead to septic shock, which is a medical emergency.

 

Avoidable hospital acquired sepsis

Sepsis may develop when you're already in hospital.
For example, you're more likely to develop sepsis if:

In the UK, hospital acquired severe sepsis accounts for about 11% of all instances of sepsis and is 100% preventable. Hospital acquired sepsis has double the mortality rate of community acquired sepsis and costs twice as much to treat11

Of the 37,000 patients that die in the UK from sepsis each year over 8,000 of them will have died of avoidable hospital acquired sepsis. This equates to 53 avoidable hospital deaths each year for each UK NHS trust.12

 

Sensium® can detect the early signs

Sepsis starts with Systemic Inflammatory Response Syndrome (SIRS) and is defined when there is a known or suspected infection plus 2 or more of:

Sensium® can be configured to send notifications at these physiological limits to warn of potential sepsis as soon as it becomes apparent. If identified early treatment can be delivered to halt the development of SIRS to severe sepsis.

Sepsis detection case study

A cardiac arrest happens when your heart stops pumping blood around your body. Most in-hospital cardiac arrests result in death within minutes – however, it is possible to recover from a cardiac arrest providing the right treatment is delivered quickly.

Cardiac arrests are usually preceded by measurable changes in a patient’s vital signs. By monitoring and reacting to these changes in vital signs, a significant proportion of in-hospital cardiac arrest deaths can be predicted and ultimately prevented.

 

Preventable in-hospital cardiac arrest

The instance of in-hospital cardiac arrest is 1.6 per 1000 hospital admissions in the UK. Currently there are approx. 15.8M hospital admissions per year16 and this puts the total number of in-hospital cardiac arrests at over 25,000. Of these 25,000 patients over 80% will not recover to discharge and this results in more than 20,000 in-hospital cardiac arrests deaths per year.

Studies have shown that of these 20,000 deaths, more than 38% are preventable and this figure represents 7700 avoidable deaths. The would equate to more than 50 avoidable deaths each year for each UK NHS trust.

 

Sensium® can detect the early signs

By continuously monitoring patients’ vital signs these changes to HR, RR and temp can be detected early. Notifications of the subtle changes that may be precursors to a cardiac arrest can be sent direct to the relevant caregiver ensuring that early clinical intervention can occur.

Possible precursors to cardiac arrest case studies

Opioid analgesics (such as morphine, methadone, and fentanyl) have been in common use for decades for the treatment and management of moderate to severe post operative pain. Of the more common side effects, respiratory depression (reduced breathing rate) is the most serious due to the real potential for death and profound brain injury.

1 in 100 patients being treated with opioids for moderate to severe post operative pain will experience events related to respiratory depression Intermittent spot checks” (nursing assessment) are not adequate for recognizing drug-induced respiratory depression
Untreated post operative respiratory depression can lead to death and profound brain injury Focus should be high risk postoperative time period (24-48 hours) for all patients rarther than high risk patient profile

Opiates and opioids are Central Nervous System (CNS) depressants. The CNS controls your ability to breathe and keep the heart beating. When depressed too far by CNS depressants, these functions can slow down or eventually stop leading to serious injury or death.

 

Preventable opioid induced respiratory complications

Around 1% of patients being treated with opioids for post operative pain management will suffer effects related to respiratory depression. Currently in the UK there are approx. 7M operations performed20  each year resulting in a potential 70,000 cases of respiratory depression.

Studies have shown that over 97% of deaths or serious brain injuries related to opioid induced respiratory depression could be avoided21 with more robust patient monitoring regimes, and that the standard level of intermittent “spot checks” may be insufficient to reliably detect the condition.

 

Sensium® can detect the early signs

Sensium continuously monitors respiratory rate and can notify clinicians of a reduced respiratory rate indicative of opioid induced respiratory depression. Studies suggest that the focus for preventing respiratory depression cases post operatively should be on the high risk time period rather than concentrating on high risk patient groups.

97% of deaths or serious brain injury following opioid induced respiratory depression are preventable21

Opioid induced respiratory complication Case studies