Giuliano Karen K
Biomed Instrum Technol. 2017 Feb;51(s2):34-43. doi: 10.2345/0899-8205-51.s2.34.
Surveillance and monitoring each represent a distinct process in patient care. Monitoring involves observation, measurement, and recording of physiological parameters, while surveillance is a systematic, goal-directed process based on early detection of signs of change, interpretation of the clinical implications of such changes, and initiation of rapid, appropriate interventions. Through use of an illustrative clinical example based on Early Warning System scoring and rapid response teams, this article seeks to distinguish between nurse monitoring and surveillance to demonstrate the impact of surveillance on improving both care processes and patient care. Using a clinical example, differences between surveillance and monitoring as a trigger for deployment of the rapid response team were reviewed. The use of surveillance versus monitoring resulted in a mean reduction in rapid response team deployment time of 291 minutes. The median hospital length of stay for patients whose clinical care included using surveillance to initiate the deployment of the rapid response team was reduced by 4 days. Monitoring relies on observation and assessment while nursing surveillance incorporates monitoring with recognition and interpretation of the clinical implications of changes to guide decisions about subsequent actions. The clinical example described here supports that the use of an automated surveillance system versus monitoring had a measurable impact on clinical care.
监测和监督在患者护理中各自代表着不同的过程。监测涉及对生理参数的观察、测量和记录，而监督是一个基于早期发现变化迹象、解读此类变化的临床意义以及启动快速、适当干预措施的系统性、目标导向的过程。通过使用一个基于早期预警系统评分和快速反应小组的示例性临床案例，本文旨在区分护士的监测和监督，以展示监督对改善护理过程和患者护理的影响。利用一个临床案例，回顾了作为快速反应小组部署触发因素的监督与监测之间的差异。使用监督而非监测使快速反应小组的部署时间平均减少了291分钟。临床护理中包括使用监督来启动快速反应小组部署的患者的中位住院时间缩短了4天。监测依赖于观察和评估，而护理监督则将监测与对变化的临床意义的识别和解读相结合，以指导关于后续行动的决策。此处描述的临床案例表明，使用自动化监督系统而非监测对临床护理产生了可衡量的影响。
