JMIR Publications

ABSTRACT

Background:

Delayed recognition of patient deterioration in non-ICU settings contributes to serious adverse events. Continuous monitoring devices with alerting systems offer real-time data to support early detection, but their effectiveness depends on usability. While prior reviews focus on clinical outcomes, usability—defined by effectiveness, efficiency, and satisfaction—remains underexplored.

Objective:

To scope the evidence related to the usability of continuous monitoring devices with deterioration alerting in non-critical adult care units.

Methods:

A scoping review was conducted following the JBI methodology and reported in accordance with PRISMA-ScR guidelines. A comprehensive search of MEDLINE, EMBASE, EMCARE, Web of Science, and IEEE Xplore was performed for studies published before November 2024. Title and abstract screening, full-text review, and data extraction were independently conducted by two reviewers. Studies were included if they (1) evaluated the usability—defined as effectiveness, efficiency, or satisfaction—of continuous monitoring devices; (2) focused on adult patients in non-ICU hospital settings; (3) used primary data; (4) were published in English; and (5) described how clinicians received alerts.

Results:

The search identified 1,284 articles, with 35 included. Most studies focused on postoperative patients in surgical wards, mainly from the US and the Netherlands. Only two used mixed methods, and 10 reported clinician characteristics. While effectiveness (71%) and efficiency (74%) were widely studied, satisfaction (46%) and usability barriers (29%) received less attention.

Conclusions:

Continuous monitoring devices with deterioration alerts can reduce RRT calls and ICU transfers, save time, and maintain acceptable alarm frequencies with high user satisfaction. However, usability challenges persist, including technical issues, alarm fatigue, patient discomfort, and limited training or workflow integration. This review mapped current use, usability, and barriers, categorized key usability factors for improvement, and identified the need for further research on clinician perspectives and broader healthcare settings to enhance generalizability.