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Keywords

clinical deterioration, early detection, patient monitoring, physiological monitoring, rapid response team, response system, vital signs

 

Authors

  1. Stellpflug, Courtney MSN, APRN, CNS
  2. Pierson, Laura BSN, RN, CMSRN
  3. Roloff, Devin MBA
  4. Mosman, Elton MBA
  5. Gross, Tera DNP, RN
  6. Marsh, Scott MBA, MSN, RN
  7. Willis, Valerie MSN, RN
  8. Gabrielson, Donald MBA, HTM

ABSTRACT:

Background: General patient acuity is increasing in the United States, with more patients having multiple comorbidities and acute-on-chronic conditions. Hospitalizations may also be complicated by serious adverse events, often unrelated to the admitting medical diagnosis. In our facility, the late detection of patient deterioration on general medical units often resulted in increased length of stay (LOS) in the ICU and poor patient outcomes.

 

Purpose: The purpose of this project was to improve patient surveillance and better identify early signs of patient deterioration through the use of continuous vital sign monitoring technology.

 

Methods: To improve detection of patient deterioration, a nurse-led monitoring and response system was developed using a wearable, wireless device for continuous vital sign surveillance. The patient data the device provided was used with early warning scores and sepsis screening protocols for timely goal-directed interventions.

 

Results: Ninety-seven percent of patient deterioration events were recognized and treated as a result of this continuous monitoring and response system. Rapid response team activations decreased by 53% between baseline and the intervention period. LOS among patients transferred to the ICU decreased from 2.82 to 2.19 days. Nurse satisfaction with use of the continuous monitoring device was positive, with 74% of nurses surveyed reporting that information provided by the device enhanced decision-making.

 

Conclusions: New technology for patient surveillance, in this case a nurse-led monitoring and response system, can be successfully integrated into general care practice. Use of the nurse-led response system helped nurses recognize early signs of deterioration and continue meaningful patient interactions.