Expectations of Continuous Vital Signs Monitoring for Recognizing Complications After Esophagectomy: Interview Study Among Nurses and Surgeons.

Mathilde van Rossum, Jobbe Leenen, Feike Kingma, Martine Breteler, Richard van Hillegersberg, Jelle Ruurda, Ewout Kouwenhoven, Marc van Det, Misha Luyer, Grard Nieuwenhuijzen, Cor Kalkman, Hermie Hermens
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引用次数: 6

Abstract

Background: Patients undergoing esophagectomy are at serious risk of developing postoperative complications. To support early recognition of clinical deterioration, wireless sensor technologies that enable continuous vital signs monitoring in a ward setting are emerging.

Objective: This study explored nurses' and surgeons' expectations of the potential effectiveness and impact of continuous wireless vital signs monitoring in patients admitted to the ward after esophagectomy.

Methods: Semistructured interviews were conducted at 3 esophageal cancer centers in the Netherlands. In each center, 2 nurses and 2 surgeons were interviewed regarding their expectations of continuous vital signs monitoring for early recognition of complications after esophagectomy. Historical data of patient characteristics and clinical outcomes were collected in each center and presented to the local participants to support estimations on clinical outcome.

Results: The majority of nurses and surgeons expected that continuous vital signs monitoring could contribute to the earlier recognition of deterioration and result in earlier treatment for postoperative complications, although the effective time gain would depend on patient and situational factors. Their expectations regarding the impact of potential earlier diagnosis on clinical outcomes varied. Nevertheless, most caregivers would consider implementing continuous monitoring in the surgical ward to support patient monitoring after esophagectomy.

Conclusions: Caregivers expected that wireless vital signs monitoring would provide opportunities for early detection of postoperative complications in patients undergoing esophagectomy admitted to the ward and prevent sequelae under certain circumstances. As the technology matures, clinical outcome studies will be necessary to objectify these expectations and further investigate overall effects on patient outcome.

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持续生命体征监测对食管切除术后并发症识别的期望:护士和外科医生的访谈研究。
背景:食管切除术患者发生术后并发症的风险很大。为了支持对临床恶化的早期识别,能够在病房环境中持续监测生命体征的无线传感器技术正在出现。目的:探讨护士和外科医生对食管切除术后住院患者无线生命体征连续监测的潜在效果和影响的期望。方法:在荷兰的3个食管癌中心进行半结构化访谈。在每个中心,对2名护士和2名外科医生进行了访谈,了解他们对食管切除术后早期识别并发症的持续生命体征监测的期望。在每个中心收集患者特征和临床结果的历史数据,并提供给当地参与者以支持对临床结果的估计。结果:大多数护士和外科医生认为,持续的生命体征监测有助于早期识别病情恶化,早期治疗术后并发症,尽管有效时间增益取决于患者和情境因素。他们对潜在的早期诊断对临床结果的影响的期望各不相同。然而,大多数护理人员会考虑在外科病房实施持续监测,以支持食管切除术后患者的监测。结论:护理人员期望无线生命体征监测能够为入院食管切除术患者术后并发症的早期发现提供机会,并在一定情况下预防后遗症。随着技术的成熟,临床结果研究将有必要客观化这些期望,并进一步研究对患者结果的总体影响。
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