Nurses' experiences with inhospital continuous monitoring of vital signs in general wards: A systematic review.

Abstract

Recent developments make the continuous monitoring of vital signs outside the critical care setting feasible, and may provide a benefit in terms of improved patient outcomes and cost efficiency. A meta-aggregative systematic review was conducted to provide an overview of the experiences of nurses working with continuous monitoring of vital signs in patients admitted to a hospital general ward. All study designs describing nurses' experiences in a qualitative manner were included. Relevant studies were identified by searching the electronic databases Pubmed, Cinahl and Embase from 2017 up to September 2024. The search strategy combined 'nurses', 'continuous monitoring/measuring', 'vital signs', and 'hospital/(general) wards' as well as synonyms. Of 3066 articles found, nine were included. Four themes were synthesized: 1) Emotional and practical advantages, e.g., patients feel safer and nurses feel more secure, as continuous monitoring detects patients deterioration earlier; 2) practical disadvantages, e.g., reduced nurse-patient interaction and stress related to changing vital signs, potential over-monitoring and data overloading; 3) important aspects related to the implementation process, e.g., training and coaching, properly working technical infrastructure; and 4) alarm strategies and clinical assessment, e.g., reducing unnecessary alarms. We conclude that nurses report varying experiences in working with continuous monitoring of vital signs on the general ward. The advantages of continuous monitoring seem to justify investing in further development of the systems and sensors in order to reduce the practical disadvantages. The findings may facilitate optimal implementation of continuous monitoring of vital signs.