Hospital patients constitute a sizable segment of the health-care system; the National Center for Health Statistics reported 39.4 million hospital stays in 2009, a 14% increase from 2005. With the growing number of hospital admissions and the worsening nursing shortage, patient safety became a priority. The Institute of Medicine identified Failure To Rescue (FTR) as a primary patient safety target in its 2001 report "Crossing the Quality Chasm: A New Health System for the Twenty-First Century."
Silber first defined failure to rescue as hospital deaths following adverse events such as post-surgical complications in 1992.
One Life Too Many
Susan McGrath, PhD, Dartmouth Hitchcock Medical Center's director of surveillance core analytics, pinpoints the case that prompted them to increase their hospital automation and continuous patient monitoring.
Following minor surgery, a patient in his 30s was admitted to a general care unit. The patient's medical history including a history of anxiety were evaluated and determined to provide low perioperative risk. The patient was given anti-anxiety medication as well as narcotics for pain and was assessed based on post operative status versus the medications administered. The patient's postoperative evaluation was normal at first. However, the patient was found deceased when the nurse returned for her regularly scheduled vital signs assessment. Unfortunately, this is not an uncommon story.
The procedure of sporadic, manual vital sign collection just does not give clinicians the ability to detect patient deterioration in a timely manner, McGrath said. Clinicians are more likely to overlook substantial changes in oxygen saturation, pulse rate, respiration rate, total hemoglobin, and other clinical measures while using manual patient monitoring. There is a lot of information that is missed by merely looking at intermittent vital signs manually, she added.
Continuous Patient Monitoring Makes a Difference
To address this issue, McGrath installed an electronic surveillance patient monitoring system in their facilities' general care settings about 15 years ago. It has since expanded its usage of automated technologies in other areas. This allows data from bedside monitors to be aggregated and delivered immediately to physicians via phones, pagers, or computers, allowing them to provide needed interventions.
This allowed them to handle a variety of issues, including information delivery delays, data loss, and a lack of awareness of dangers, warning signs, and potential outcomes. Perhaps most critically, the hospital is utilizing automated technologies to assist physicians in dealing with the "noise" associated with all of the extraneous information they are normally overwhelmed with when caring for patients.
Additionally, a published study from McGrath found:
- Of 111,488 patients who were monitored during this time period, none died or experienced opioid-produced respiratory depression
- 1 unmonitored patient died on a unit that had continuous monitoring available
- Out of the 15,209 unmonitored patients, three died
To summarize the findings, continuous monitoring of all patients in all settings is found to be crucial in order to prevent deterioration from progressing too far and to deliver resources to the bedside in an efficient manner that allows patients to get timely treatment.
Continuous Patient Monitoring Device for Comfort and Results
Typically, vital signs are measured every 4-8 hours, using equipment rolled from room to room, with little to no cleaning between patients. If the patient has traditional continuous vital sign monitoring ordered, they are likely tethered to the monitoring equipment, making normal activities like eating and drinking more difficult and taking a simple walk to the bathroom nearly impossible and definitely more dangerous. Setting up and cleaning this type of equipment between patients can be time demanding for nurses and manual checks leave room for patient deterioration to be missed.
ViSi Mobile offers an alternative, the system includes comfortable body-worn sensors that allow for freedom of movement and precise, continuous monitoring of all essential vital signs, including noninvasive blood pressure, lethal arrhythmia detection (V Tach/V Fib/Asystole), and Atrial Fibrillation detection as well as patient activity, fall detection and posture.
Also, the continuous patient monitoring capabilities provided by the ViSi Mobile enhance clinician efficiency and minimizes the number of unmonitored patients both inside and outside of emergency rooms. It is a platform for comprehensive vital signs monitoring that keeps clinicians connected to their patients whether in bed, in transport, or ambulating.
Compatibility-wise, based on lab and live testing, the ViSi Mobile Monitor can coexist with a variety of medical and enterprise equipment. It can connect to most EMR systems using HL7 or middleware such as Capsule. Epic, Cerner, Meditech, and HMS/Medhost are among the active integrations.
Any plans on improving your existing patient monitoring systems and adding more features? Learn more about how ViSi Mobile can work with your current systems.
