Jobbe Pl Leenen, Lisette Schoonhoven, Gijs A Patijn
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引用次数: 0
摘要
审查目的:用于连续生命体征监测(CVSM)的可穿戴无线传感器为早期识别患者病情恶化提供了可能,尤其是在普通病房等低强度护理环境中。本研究旨在回顾可穿戴连续生命体征监测的进展,重点关注普通病房,通过探讨最新证据,突出连续生命体征监测系统的技术特点、用户观点以及对患者预后的影响:最近的研究结果:测量生命体征的可穿戴传感器的准确性存在变数,这一点在医院环境中的非卧床病人身上尤为明显,而且缺乏标准的验证协议。CMVS系统的易用性对护士和患者来说至关重要,因此需要易于使用的可穿戴传感器,并增加测量生命体征的数量。目前的软件系统缺乏与医院 IT 基础设施和工作流程自动化的整合。亟待改进的是护士友好型、侵入性较低的报警策略和先进的决策支持系统。小结:CVSM 系统在普通病房以及医院外的广泛应用似乎不可避免。尽管 CVSM 系统在改善临床预后和通过优化临床工作流程效率支持护理方面具有理论上的优势,但在临床实践中的效果却参差不齐。本综述强调了目前在数据质量、可用性、实施、集成、解释和用户视角等方面存在的挑战,以及需要强有力的证据来证明其对患者预后、工作流程和成本效益的影响。
Wearable wireless continuous vital signs monitoring on the general ward.
Purpose of review: Wearable wireless sensors for continuous vital signs monitoring (CVSM) offer the potential for early identification of patient deterioration, especially in low-intensity care settings like general wards. This study aims to review advances in wearable CVSM - with a focus on the general ward - highlighting the technological characteristics of CVSM systems, user perspectives and impact on patient outcomes by exploring recent evidence.
Recent findings: The accuracy of wearable sensors measuring vital signs exhibits variability, especially notable in ambulatory patients within hospital settings, and standard validation protocols are lacking. Usability of CMVS systems is critical for nurses and patients, highlighting the need for easy-to-use wearable sensors, and expansion of the number of measured vital signs. Current software systems lack integration with hospital IT infrastructures and workflow automation. Imperative enhancements involve nurse-friendly, less intrusive alarm strategies, and advanced decision support systems. Despite observed reductions in ICU admissions and Rapid Response Team calls, the impact on patient outcomes lacks robust statistical significance.
Summary: Widespread implementation of CVSM systems on the general ward and potentially outside the hospital seems inevitable. Despite the theoretical benefits of CVSM systems in improving clinical outcomes, and supporting nursing care by optimizing clinical workflow efficiency, the demonstrated effects in clinical practice are mixed. This review highlights the existing challenges related to data quality, usability, implementation, integration, interpretation, and user perspectives, as well as the need for robust evidence to support their impact on patient outcomes, workflow and cost-effectiveness.
期刊介绍:
Current Opinion in Critical Care delivers a broad-based perspective on the most recent and most exciting developments in critical care from across the world. Published bimonthly and featuring thirteen key topics – including the respiratory system, neuroscience, trauma and infectious diseases – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.