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Int J Qual Health Care · Sep 2016
Vital signs monitoring on general wards: clinical staff perceptions of current practices and the planned introduction of continuous monitoring technology.
- Mirela Prgomet, Magnolia Cardona-Morrell, Margaret Nicholson, Rebecca Lake, Janet Long, Johanna Westbrook, Jeffrey Braithwaite, and Ken Hillman.
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Level 6, 75 Talavera Road, Macquarie University, Sydney NSW 2109, Australia.
- Int J Qual Health Care. 2016 Sep 1; 28 (4): 515-21.
ObjectiveEarly detection of patient deterioration and prevention of adverse events are key challenges to patient safety. This study investigated clinical staff perceptions of current monitoring practices and the planned introduction of continuous monitoring devices on general wards.DesignMulti-method study comprising structured surveys, in-depth interviews and device trial with log book feedback.SettingTwo general wards in a large urban teaching hospital in Sydney, Australia.ParticipantsRespiratory and neurosurgery nursing staff and two doctors.ResultsNurses were confident about their abilities to identify patients at risk of deterioration, using a combination of vital signs and visual assessment. There were concerns about the accuracy of current vital signs monitoring equipment and frequency of intermittent observation. Both the nurses and the doctors were enthusiastic about the prospect of continuous monitoring and perceived it would allow earlier identification of patient deterioration; provide reassurance to patients; and support interdisciplinary communication. There were also reservations about continuous monitoring, including potential decrease in bedside nurse-patient interactions; increase in inappropriate escalations of patient care; and discomfort to patients.ConclusionsWhile 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.© The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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