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为 COVID-19 患者构建实时远程患者监测患者安全计划。

Building a Real-Time Remote Patient Monitoring Patient Safety Program for COVID-19 Patients.

机构信息

Division of Hospital Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO.

UCHealth, Aurora, CO.

出版信息

Am J Med Qual. 2022;37(4):342-347. doi: 10.1097/JMQ.0000000000000046. Epub 2022 Feb 23.

Abstract

Coronavirus disease 2019 (COVID-19) pandemic has forced providers to rapidly adopt telehealth tools to reduce staff exposure to ill persons, preserve personal protective equipment, and minimize impact of patient surges on facilities. Remote patient monitoring (RPM) can be used to monitor high-risk patients from their homes and open up hospital bed availability. The authors describe a pilot program to evaluate the impact of RPM in postdischarge monitoring of COVID-19 patients. High-risk patients discharging from the hospital received a wearable vital sign monitoring device to be worn for 8 consecutive days, allowing real-time data transmission to a virtual health center (VHC), which had been established prior to the pandemic, via a smart phone application. The data were monitored 24 hours a day by a VHC tech with built-in escalation protocols to a nurse and/or an attending physician if needed. Eighty patients were enrolled, 48% women with an age range of 19-83 years. Languages included Spanish (49%), English (47%), Burmese (2%), and Swahili (1%). The most common comorbidities included hypertension (48%) and diabetes mellitus (48%). Oxygen was the most common addressed need; 8% requiring new oxygen and 8% benefitting from oxygen-weaning during the RPM time period. Ten percent patients had emergency department (ED) visits and 4% were readmitted within 30 days of discharge. The authors built and deployed an RPM program for postdischarge monitoring of high-risk patients. RPM can be quickly deployed to support COVID-19 patients postdischarge and assist with hospital capacity. RPM can be rapidly and successfully deployed during the COVID 19 pandemic to aid in transitions of care.

摘要

新型冠状病毒病 2019(COVID-19)大流行迫使医疗服务提供者迅速采用远程医疗工具,以减少员工接触病人,保护个人防护设备,并最大限度地减少病人激增对设施的影响。远程病人监测(RPM)可用于从家中监测高危病人,并开放医院病床。作者描述了一项试点计划,以评估 RPM 在 COVID-19 患者出院后监测中的影响。从医院出院的高危病人会收到一个可穿戴的生命体征监测设备,需要连续佩戴 8 天,通过智能手机应用程序实时将数据传输到一个预先建立的虚拟健康中心(VHC)。VHC 的技术人员每天 24 小时监控数据,如果需要,会根据内置的升级协议向护士和/或主治医生升级。共有 80 名患者入组,其中 48%为女性,年龄在 19-83 岁之间。语言包括西班牙语(49%)、英语(47%)、缅甸语(2%)和斯瓦希里语(1%)。最常见的合并症包括高血压(48%)和糖尿病(48%)。最常见的需要解决的问题是氧气,8%需要新的氧气,8%在 RPM 期间受益于脱氧。10%的患者到急诊部(ED)就诊,4%的患者在出院后 30 天内再次入院。作者为高危病人的出院后监测建立并部署了 RPM 方案。RPM 可迅速用于支持 COVID-19 患者出院后,并帮助增加医院容量。RPM 可以在 COVID-19 大流行期间迅速而成功地部署,以帮助过渡护理。

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