Surveillance Monitoring
Surveillance monitoring represents a unique opportunity to improve the delivery of high quality, safe, effective healthcare. Early detection of patient deterioration is essential to early intervention and rapid response, but the standard for routine rounding and vital sign measurement has not kept pace with increasing patient acuity. The majority of acutely ill hospitalized patients remain unmonitored, even though approximately half of all hospital deaths occur in the unmonitored population. Cardiac telemetry, although widely used, has been shown to have no significant clinical value in patients who do not have either a preexisting abnormal electrocardiogram or a diagnosis of a cardiac disorder. Investigators note that the use of continuous vital sign monitoring systems (aka surveillance systems) in the general care setting represents a more proactive approach to identifying patient deterioration, based upon the premise that physiologic changes can indicate, and perhaps predict, deterioration episodes.
Successfully rescuing a deteriorating patient includes recognition that the patient requires acute intervention reporting that knowledge to appropriate personnel, and an effective response. In-hospital mortality studies show that patients frequently manifest signs of deterioration six to twelve hours prior to a clinical ‘event.’ All too often, failure-to-rescue is the result of failure to recognize; surveillance monitoring is a key technology, enabling both the recognition and reporting of physiological instability.
Nurses play a pivotal role in preventing and identifying complications and, therefore, are critically involved in recognizing and rescuing patients from deterioration following complications. Nurse leadership is therefore essential to ensure the appropriate re-sources, protocols, equipment and education are available to help medical/surgical nurses overcome reluctance to act upon abnormal vital signs. Engagement in a rapid response system enables nurses to exert independent judgment, bypassing the traditional hospital hierarchy in order to obtain help. No nurse should enter a room and unexpectedly find a patient in extremis or worse; surveillance monitoring provides an important safeguard, protecting patients when the nurse is absent, in order to prevent such a catastrophe from happening.
Setting appropriate parameters to identify patient deterioration is essential. The purpose of an alert is to attract attention and initiate action from a responsible recipient. Alarm fatigue is a national concern hence Sotera’s focus on maximizing the ‘actionability’ of our alerts; we provide a best practice approach which is objective and data-driven to define alarm thresholds and annunciation delays.
The ViSi Mobile Patient Monitoring System (FDA cleared for patient use), is the first body-worn, multi-parameter wireless surveillance monitoring platform. The wrist-worn monitor is a fully functional continuous monitoring device, comparable to a bedside or transport monitor but dramatically smaller and lighter which can operate independently or as part of a wireless network. The device weighs ~4 oz., and is equipped with a color touch-screen which can display all vital signs and waveforms. The monitor provides local viewing, local control, local alarming, and has a sealed battery that lasts >12 hours on a single charge.
When early detection matters, ViSi Mobile can make the difference.