Maximizing Clinical Workflow with the ViSi Mobile Monitoring System
The current process for obtaining vital signs in medical-surgical units is not ideal. Typically, vital signs are obtained every 4 to 8 hours on a medical-surgical unit and are manually entered into the patient’s Electronic Medical Record. Often, this data entry is delayed due to the bedside staff having a series of patient tasks that must be taken care of, all at the same time.
The bedside staff tends to document the vital signs on a piece of paper and enter them into the patients’ EMRs once they have finished obtaining the vital signs for all of their patients. “Clinicians have been found to regularly enter data incorrectly into the electronic medical record (EMR), delay entry of data until long after it has been obtained from the patient, and even omit entries until shift-end” (Fieler, Jaglowski, & Richards, 2013). This is because they are busy with many other tasks at once, which means they may not be able to enter the vital signs into the EMR as they should.
This can cause problems for patients who need their information to make decisions about their health care. The correct data needs to be entered into their EMRs to access it when needed. This also results in incomplete and inaccurate documentation of vitals data which can lead to patient safety issues such as incorrect lab results or failure to identify critical changes in a patient’s condition.
Entering vital signs manually into an EMR can be time-consuming and prone to error because it requires clinicians to check off each item on their list. To address this delayed documentation, hospitals are now working with medical device companies to integrate the data from their devices with the EMR. This shift in the way vital signs are documented is based on studies that have found “that this type of system integration can potentially reduce the time spent on manual entry of information in the EMR and support other value-added activities in the hospital.”
One study on medical device integration and vital sign documentation noted an “unexpected comment from a nurse [that] involved downstream patient care activities seemingly unrelated to the device integration. Nurses are advised in hospital policy to have recent vital signs recorded before administering a high-risk medication. This leads to delays when vital signs have already been taken by ancillary care staff but have not been documented in the EMR. It is inadvisable from a patient satisfaction perspective to repeatedly take vital signs in a short period for non-acuity-related reasons, so nursing staff would then try to reach the PCA or other ancillary staff that obtained the measurements before administering the medication. Depending on the workload and availability of staff, this could delay medication administration.”
Based on these findings, the authors “Investigated if there [was] a significant difference in the time taken to fire a MEWS warning…and determined that the time taken to fire the warning was significantly smaller (by ~ 30 min) when the integrated system was used”. Additionally, the researchers found that vitals entry using the integrated device [was] significantly faster” with the “average time to enter vitals [being] significantly reduced from 19.5 min to 1.382 min when the integrated device [was] used”.
“The implementation of the integration system had a significant impact on both the documentation delay for all vital signs taken and on the delay between vital signs being taken and the alert regarding the declining hemodynamic status of the patient. The clinical implications of such an improvement are notable.”
The ViSi Mobile System proposes a solution that allows for real-time entry of vitals data when obtained by nursing staff at point-of-care (POC) devices such as smartphones or tablets. It is designed to provide continuous surveillance monitoring for patients in general care settings, thereby improving patient safety by utilizing machine learning from millions of hours of patient data to recognize patient deterioration while minimizing alarm burden and maximizing clinical workflow.
The Visi Mobile System monitors:
It is designed to detect deterioration earlier and keep clinicians connected to their patients. Featuring wearable sensors that allow for freedom of movement, the system enables highly accurate, continuous monitoring of core vital signs.
The ViSi Mobile Monitors integrate with a hospital’s existing 802.11 networks. The standard system consists of 3 main components:
- ViSi Mobile Monitor – Worn by the patient and communicates with the ViSi Mobile Appliance over the wireless network using an 802.11 radio.
- ViSi Mobile System Software – Installed on a physical or virtual server; the System software compiles and distributes patient information to the ViSi Mobile Remote Viewer(s).
- ViSi Mobile Remote Viewer – Central station that allows the user to view patient vital signs and other continuous data