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重症术后患者的远程监测:生物传感器实施试验的经验教训

Remote Monitoring of Critically-Ill Post-Surgical Patients: Lessons from a Biosensor Implementation Trial.

作者信息

Restrepo Mariana, Huffenberger Ann Marie, Hanson C William, Draugelis Michael, Laudanski Krzysztof

机构信息

College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA.

Penn Medicine Center for Connected Care, Clinical Practices of the University of Pennsylvania, Philadelphia, PA 19104, USA.

出版信息

Healthcare (Basel). 2021 Mar 18;9(3):343. doi: 10.3390/healthcare9030343.

Abstract

Biosensors represent one of the numerous promising technologies envisioned to extend healthcare delivery. In perioperative care, the healthcare delivery system can use biosensors to remotely supervise patients who would otherwise be admitted to a hospital. This novel technology has gained a foothold in healthcare with significant acceleration due to the COVID-19 pandemic. However, few studies have attempted to narrate, or systematically analyze, the process of their implementation. We performed an observational study of biosensor implementation. The data accuracy provided by the commercially available biosensors was compared to those offered by standard clinical monitoring on patients admitted to the intensive care unit/perioperative unit. Surveys were also conducted to examine the acceptance of technology by patients and medical staff. We demonstrated a significant difference in vital signs between sensors and standard monitoring which was very dependent on the measured variables. Sensors seemed to integrate into the workflow relatively quickly, with almost no reported problems. The acceptance of the biosensors was high by patients and slightly less by nurses directly involved in the patients' care. The staff forecast a broad implementation of biosensors in approximately three to five years, yet are eager to learn more about them. Reliability considerations proved particularly troublesome in our implementation trial. Careful evaluation of sensor readiness is most likely necessary prior to system-wide implementation by each hospital to assess for data accuracy and acceptance by the staff.

摘要

生物传感器是众多有望用于拓展医疗服务的技术之一。在围手术期护理中,医疗服务系统可利用生物传感器对原本需要住院的患者进行远程监测。由于新冠疫情,这项新技术在医疗领域得以显著加速发展并站稳脚跟。然而,很少有研究试图描述或系统分析其实施过程。我们对生物传感器的实施情况进行了一项观察性研究。将市售生物传感器提供的数据准确性与重症监护病房/围手术期病房收治患者的标准临床监测数据进行了比较。我们还开展了调查,以了解患者和医务人员对该技术的接受程度。我们发现传感器与标准监测在生命体征方面存在显著差异,这在很大程度上取决于所测量的变量。传感器似乎能相对较快地融入工作流程,几乎没有报告出现问题。患者对生物传感器的接受度较高,而直接参与患者护理的护士接受度略低。工作人员预计生物传感器将在大约三到五年内得到广泛应用,但他们也渴望更多地了解这些传感器。在我们的实施试验中,可靠性问题尤其棘手。每家医院在全系统实施之前,很可能有必要对传感器的准备情况进行仔细评估,以评估数据准确性和工作人员的接受度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74c1/8002865/7eeee8467aa7/healthcare-09-00343-g001.jpg

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