Leeds Institute of Biomedical & Clinical Sciences, Clinical Sciences Building, St. James's University Hospital, University of Leeds, Leeds, LS9 7TF, United Kingdom.
Leeds Institute of Clinical Trials Research, Worsley Building, University of Leeds, Leeds, LS2 9NL, United Kingdom.
Int J Med Inform. 2018 Jun;114:52-56. doi: 10.1016/j.ijmedinf.2018.03.014. Epub 2018 Mar 27.
Vital signs monitoring is used to identify deteriorating patients in hospital. The most common tool for vital signs monitoring is an early warning score, although emerging technologies allow for remote, continuous patient monitoring. A number of reviews have examined the impact of continuous monitoring on patient outcomes, but little is known about the patient experience. This study aims to discover what patients think of monitoring in hospital, with a particular emphasis on intermittent early warning scores versus remote continuous monitoring, in order to inform future implementations of continuous monitoring technology.
Semi-structured interviews were undertaken with 12 surgical inpatients as part of a study testing a remote continuous monitoring device. All patients were monitored with both an early warning score and the new device. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis.
Patients can see the value in remote, continuous monitoring, particularly overnight. However, patients appreciate the face-to-face aspect of early warning score monitoring as it allows for reassurance, social interaction, and gives them further opportunity to ask questions about their medical care.
Early warning score systems are widely used to facilitate detection of the deteriorating patient. Continuous monitoring technologies may provide added reassurance. However, patients value personal contact with their healthcare professionals and remote monitoring should not replace this. We suggest that remote monitoring is best introduced in a phased manner, and initially as an adjunct to usual care, with careful consideration of the patient experience throughout.
生命体征监测用于识别医院中病情恶化的患者。生命体征监测最常用的工具是早期预警评分，尽管新兴技术允许进行远程、连续的患者监测。已经有许多研究评估了连续监测对患者结局的影响，但对于患者体验知之甚少。本研究旨在发现患者对医院监测的看法，特别关注间歇性早期预警评分与远程连续监测，以为连续监测技术的未来实施提供信息。
作为测试远程连续监测设备的研究的一部分，对 12 名外科住院患者进行了半结构化访谈。所有患者均同时接受早期预警评分和新设备监测。对访谈进行了录音、逐字转录，并使用主题分析进行了分析。
患者可以看到远程连续监测的价值，尤其是在夜间。然而，患者欣赏早期预警评分监测的面对面方面，因为它可以提供安心、社交互动，并让他们有更多机会询问有关医疗护理的问题。
早期预警评分系统广泛用于促进病情恶化患者的检测。连续监测技术可能提供额外的安心。然而，患者重视与他们的医疗保健专业人员的个人接触，远程监测不应替代这种接触。我们建议以分阶段的方式引入远程监测，最初作为常规护理的辅助手段，并在整个过程中仔细考虑患者体验。
