Feasibility And Efficacy Of Continuous In-Hospital Patient Monitoring

Study Overview
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Brief Summary
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The investigators plan to study patients who have had cardiac surgery. Current standard practice is to monitor patients who have had cardiac surgery using wall-mounted monitors whilst they are on the Overnight Intensive Recovery (OIR) and the cardiac High Dependency Unit (HDU). The wall-mounted monitors monitor the vital signs continuously and alert the nurses if any abnormalities are detected. Once a patient is transferred from HDU to the cardiac surgery ward for the most part they are no longer connected to a continuous monitor. Instead, the majority of patients on the ward have their vital signs only intermittently checked during the day, using a spot check monitor. There is a small minority, chosen on clinical grounds, who are assessed with wireless telemetry monitors for a day or two. In this study the investigators will continuously monitor the vital signs of all enrolled patients from the time that they leave the operating theatre to the the time they are discharged from hospital. Whilst they are on OIR and HDU they will be monitored with the standard wall-mounted monitors in the normal fashion. When they then move to the ward the investigators will give all enrolled patients a telemetry monitor to wear as well as asking the nurses to check their vital signs with spot check monitors. The investigators will also collect information about the patients' general state of health and record indicators of worsening in patients' condition so that the investigators can determine how changes in the vital signs relate to deterioration. Finally the investigators plan to survey the patients and nurses to understand their experiences of continuous monitoring and what needs to be changed to improve the patient experience.

Official Title
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Feasibility And Efficacy Of Continuous In-Hospital Patient Monitoring

Conditions
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Monitoring of Patients Following Surgery

Intervention / Treatment
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* Device: Fitting of a wireless telemetry device


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult (aged over 18 years old) Planned for elective cardiac surgery Post surgery care is planned to be on a study ward Exclusion Criteria: Inability or refusal to consent Pregnant Prisoners For palliative care only

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Elective cardiac surgery patients<br>Patients undergoing elective cardiac surgery | Device: Fitting of a wireless telemetry device<br>* Fitting of a Philips Intellivue Trx + SpO2 telemetry device. To be worn throughout patient stay except if being monitored using a standard bedside monitor or bathing.<br>* Other names: Philips Intellivue Trx + SpO2;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The number of patients in whom abnormal vital signs are detected by a continuous monitor more than an hour before they are detected according to standard ward practice |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The proportion of patient stay for which good quality continuous data is captured |  |  | 
| The number of alerts caused by probe off alarms and artefactual readings |  |  | 
| The sensitivity of the automated early warning score developed from this data for predicting clinical deterioration |  |  | 
| The specificity of the automated early warning score developed from this data for predicting clinical deterioration |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Early warning score, Physiological score, Track and trigger score, Scoring system, Physiological model, Monitoring, Patient monitoring, Wireless monitoring, Wearable monitor