Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 17, 2024
Date Accepted: Sep 7, 2024
Effectiveness of Remote Patient Monitoring Equipped with an Early Warning System in Tertiary Care Hospital Wards: A Retrospective Cohort Study
ABSTRACT
Background:
Monitoring vital signs in hospitalized patients is crucial for evaluating their clinical condition. While early warning scores like the modified early warning score (MEWS) are typically calculated three to four times daily through spot checks, they might not promptly identify early deterioration. Leveraging technologies that provide continuous monitoring of vital signs, combined with an early warning system, has the potential to identify clinical deterioration sooner. This approach empowers healthcare providers to intervene promptly and effectively.
Objective:
The impact of a Remote Patient Monitoring System (RPMS) on patient safety in non-critical care at a tertiary hospital. RPMS performance was compared with Simulated Modified Early Warning System (S-MEWS) and threshold-based alert systems (S-Threshold).
Methods:
Patient outcomes, including ICU transfers due to deterioration and discharges for non-deteriorating cases, were analyzed in Ramaiah Memorial Hospital's general wards with RPMS. Sensitivity, specificity, Chi-square test for alert frequency distribution equality, the average time from the first alert to ICU transfer in the last 24 hours was determined. Alert and patient distribution by tiers and vitals in RPMS groups were examined. Time spent by healthcare professionals in both RPMS and non-RPMS wards was quantified.
Results:
Analyzing 905 patients, including 38 with deteriorations, RPMS, S-Threshold, and S-MEWS generated more alerts for deteriorating cases. RPMS showed high sensitivity (97.37%) and low specificity (23.41%), S-Threshold had perfect sensitivity (100%) but low specificity (0.46%), and S-MEWS demonstrated moderate sensitivity (47.37%) and high specificity (81.31%). The average time from initial alert to clinical deterioration was at least 18 hours for RPMS and S-Threshold in deteriorating subjects. RPMS had increased alert frequency and a higher proportion of critical alerts for deteriorating cases. RPMS streamlined monitoring, freeing up 2.12 extra hours per day for direct patient care.
Conclusions:
This study underscores RPMS's role in early deterioration detection, emphasising timely interventions for improved patient outcomes. Continuous monitoring enhances patient safety, and optimises care quality. Clinical Trial: Not Applicable Retrospective Study
Citation
Per the author's request the PDF is not available.
Copyright
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