JMIR Publications

ABSTRACT

Background:

The growing ageing population and staff shortages are placing pressure on Dutch nursing homes (NHs). These challenges have led to an increased interest in digital health technologies. Among these are wearable devices that allow for remote continuous monitoring of vital signs. An example is the Healthdot, a wearable electronic device that continuously monitors heart rate, respiratory rate, and physical activity. In the context of acute respiratory infections (ARIs) in NHs, where initial symptoms can go unnoticed, continuous monitoring may aid early recognition, timely intervention, and reduce staff workloads. However, little is known about how healthcare professionals perceive the use of continuous vital signs monitoring devices such as the Healthdot for this cause in NHs.

Objective:

To explore the perspectives of healthcare professionals on the use of the Healthdot for monitoring ARIs in NHs, to inform potential future implementation.

Methods:

Semi-structured interviews were conducted with 20 physicians, nurses, and certified nursing assistants from four NHs and one acute geriatric community hospital (AGCH) located in a NH. Interview transcripts were thematically analysed to identify themes regarding their perspectives on the use of the Healthdot for monitoring ARIs in this setting.

Results:

Five main themes were identified that related to the appropriate use of the Healthdot for clients and healthcare professionals: alignment of Healthdot use and clients’ treatment policies, balancing safety and freedom, impact of the Healthdot on work processes, supporting rather than replacing care, and possible use in pandemics and the future. Additionally, several preconditions for the use of the Healthdot were identified, including its usability, a support base among care staff, adequate training and guidance, communication to clients and their relatives, and a clear policy regarding its use.

Conclusions:

Given the complexity of care in NHs, where clinical care is typically balanced against quality of life and a homelike environment, physicians generally expressed reserved attitudes toward the Healthdot, highlighting the need to consider multiple factors in its implementation. Care staff were generally positive about the device. Nevertheless, tailored assessment for each individual client is remains essential, balancing treatment goals, safety, autonomy, and person-centred care. Additionally, clear communication and alignment between healthcare professionals in this setting is crucial, specifically regarding their expectations of the Healthdot’s role in care processes. This study offers practical guidance that may inform future implementation efforts of continuous vital sign monitoring devices in NHs.