Weller Grant B, Mault James, Ventura Maria Eloisa, Adams Justin, Campbell Frank J, Tremper Kevin K
BioIntelliSense, Inc., Golden, CO 80401, USA.
Ardent Health Services, Nashville, TN 37027, USA.
J Clin Med. 2024 Aug 13;13(16):4747. doi: 10.3390/jcm13164747.
Continuous vital sign monitoring via wearable technology, combined with algorithm-based notifications, has been utilized for early detection of patient deterioration. In this retrospective observational study, we summarize a large-scale implementation of a continuous monitoring system in medical-surgical units of two hospitals over the course of fifteen (15) months. : An FDA-cleared wireless monitoring device (BioButton, BioIntelliSense Inc., Golden, CO, USA), was placed on each patient upon admission. The wearable device measures heart rate and respiratory rate at rest, skin temperature, and patient activity levels. High-frequency data (up to 1440 measurements per day) are transmitted to display in exception management software (BioDashboard™, version 2.9, BioIntelliSense Inc.). Algorithmic and rules-based notifications are triggered based on clinical and statistical trending criteria. We present (i) agreement of device readings with bedside charted measurements, (ii) the frequency of notifications, (iii) the occurrence of notifications prior to clinical deterioration events, and (iv) impact on clinical management, including early data on length of stay (LOS). : In total, 11,977 patient encounters were monitored at two sites. Bias ±95% limits of agreement were 1.8 ± 12.5 for HR and 0.4 ± 8.0 for RR. The rates of notifications were 0.97 and 0.65 per patient-day at Sites 1 and 2, respectively. Among clinical deteriorations, 73% (66%) had at least one notification within 24 h prior at Site 1 (Site 2). At Site 1, there were 114 cases for which a notification led to a new or changed physician's order. LOS in the first unit monitored by the system exhibited a decreasing trend from 3.07 days to 2.75 days over 12 months. : Wearable continuous vital sign monitoring with the BioIntelliSense BioButton system enables early detection of clinical deterioration.
通过可穿戴技术进行持续生命体征监测，并结合基于算法的通知，已被用于早期发现患者病情恶化。在这项回顾性观察研究中，我们总结了在两家医院的内科 - 外科病房中，连续监测系统在十五（15）个月内的大规模实施情况。：一种经美国食品药品监督管理局（FDA）批准的无线监测设备（BioButton，BioIntelliSense公司，美国科罗拉多州戈尔登）在患者入院时放置在每位患者身上。该可穿戴设备测量静息心率、呼吸频率、皮肤温度和患者活动水平。高频数据（每天多达1440次测量）被传输到异常管理软件（BioDashboard™，版本2.9，BioIntelliSense公司）中显示。基于临床和统计趋势标准触发基于算法和规则的通知。我们展示了（i）设备读数与床边记录测量值的一致性，（ii）通知的频率，（iii）临床恶化事件之前通知的发生情况，以及（iv）对临床管理的影响，包括住院时间（LOS）的早期数据。：在两个地点共监测了11977例患者就诊情况。心率（HR）的偏差±95%一致性界限为1.8±12.5，呼吸频率（RR）为0.4±8.0。第1和第2地点的通知率分别为每位患者每天0.97次和0.65次。在临床恶化病例中，第1地点（第2地点）73%（66%）在24小时内至少有一次通知。在第1地点，有114例通知导致了新的或更改的医生医嘱。该系统监测的第一个科室的住院时间在12个月内从3.07天呈下降趋势至2.75天。：使用BioIntelliSense BioButton系统进行可穿戴连续生命体征监测能够早期发现临床恶化。
