院内和院外生命体征监测——同一枚硬币的两面：来自 LIMS 和 Greenline-HT 研究操作人员的观点。
Intra- and Extra-Hospitalization Monitoring of Vital Signs-Two Sides of the Same Coin: Perspectives from LIMS and Greenline-HT Study Operators.
机构信息
Internal Medicine Unit, Castelli Hospital, Asl Roma 6, 00072 Rome, Italy.
Departmental Faculty of Medicine, St. Camillus University of Medicine and Health Sciences, 00131 Rome, Italy.
出版信息
Sensors (Basel). 2023 Jun 7;23(12):5408. doi: 10.3390/s23125408.
BACKGROUND
In recent years, due to the epidemiological transition, the burden of very complex patients in hospital wards has increased. Telemedicine usage appears to be a potential high-impact factor in helping with patient management, allowing hospital personnel to assess conditions in out-of-hospital scenarios.
METHODS
To investigate the management of chronic patients during both hospitalization for disease and discharge, randomized studies (LIMS and Greenline-HT) are ongoing in the Internal Medicine Unit at ASL Roma 6 Castelli Hospital. The study endpoints are clinical outcomes (from a patient's perspective). In this perspective paper, the main findings of these studies, from the operators' point of view, are reported. Operator opinions were collected from structured and unstructured surveys conducted among the staff involved, and their main themes are reported in a narrative manner.
RESULTS
Telemonitoring appears to be linked to a reduction in side-events and side-effects, which represent some of most commons risk factors for re-hospitalization and for delayed discharge during hospitalization. The main perceived advantages are increased patient safety and the quick response in case of emergency. The main disadvantages are believed to be related to low patient compliance and an infrastructural lack of optimization.
CONCLUSIONS
The evidence of wireless monitoring studies, combined with the analysis of activity data, suggests the need for a model of patient management that envisages an increase in the territory of structures capable of offering patients subacute care (the possibility of antibiotic treatments, blood transfusions, infusion support, and pain therapy) for the timely management of chronic patients in the terminal phase, for which treatment in acute wards must be guaranteed only for a limited time for the management of the acute phase of their diseases.
背景
近年来，由于流行病学的转变，医院病房中非常复杂的患者负担增加。远程医疗的使用似乎是帮助患者管理的一个潜在的高影响力因素，可以让医院人员评估院外场景中的情况。
方法
为了在疾病住院和出院期间调查慢性患者的管理，正在 ASL Roma 6 Castelli 医院内科病房进行随机研究（LIMS 和 Greenline-HT）。研究终点是临床结果（从患者的角度来看）。在这篇观点文章中，从运营商的角度报告了这些研究的主要发现。从参与的员工中进行了结构化和非结构化调查，收集了运营商的意见，并以叙述的方式报告了他们的主要主题。
结果
远程监测似乎与减少副作用和副作用有关，这些副作用是再住院和住院期间延迟出院的一些最常见的危险因素。主要的感知优势是提高了患者的安全性和在紧急情况下的快速反应。主要的缺点被认为与患者的低顺应性和基础设施缺乏优化有关。
结论
无线监测研究的证据，结合活动数据的分析，表明需要一种患者管理模式，设想增加能够为患者提供亚急性护理的结构的领土（提供抗生素治疗、输血、输液支持和疼痛治疗的可能性），以便及时管理慢性患者的终末期，对于必须在急性病房中保证治疗的疾病急性阶段的患者，仅需要有限的时间。
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