Clinical Outcomes After Implementation of COntinuous Vital Sign Monitoring On the General Ward.

Study Overview
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Brief Summary
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In 2018, continuous monitoring (CM) of 5 vital signs with a wearable device, including automated MEWS calculation within the EMR were introduced on the surgical and internal medicine ward of our hospital. Rather than taking the measurements manually, this enabled the nurses to periodically validate the continuously derived vital signs at the protocolled moments, and simultaneously get an automatically calculated MEWS reading,. Moreover, continuous vital sign monitoring provides single channel alarms and trends of the vital signs in between the regular measurement moments. Compared to periodic manual measurements and registration in the EMR, the continuous vital sign monitoring and automated MEWS calculations in the EMR may result in better identification of clinical deterioration, and may improve clinical outcome. The primary objective of this study is to evaluate changes in total hospital and ward stay, Total Events during admission (rapid response team (RRT) calls and unexpected intensive care unit (uICU) admissions and deaths) after implementation of CM on the regular surgical and internal medicine wards. Secondary objective is to evaluate changes in MEWS scores at the moment of the uICU admissions, length of hospital, ward and ICU stay and the proportion of RRT calls that results in a ICU admission.

Official Title
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Clinical Outcomes After Implementation of Continuous Vital Sign Monitoring on the General Ward.

Conditions
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Clinical Deterioration

Intervention / Treatment
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* Other: Continuous Monitoring


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Admission on Inclusion ward. Exclusion Criteria: Opt out of file study

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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| General Ward Inpatients 2017-2018<br>ALL General Ward Inpatients on our Gastro-Enterology Surgery ward and Internal Medicine ward in the period august 1st 2017-august 31st 2018. | |
| General Ward Inpatients 2018-2019<br>ALL General Ward Inpatients on our Gastro-Enterology Surgery ward and Internal Medicine ward in the period august 1st 2018-august 31st 2019. | Other: Continuous Monitoring<br>* Wireless continuous vital sign monitoring (HR, RR, SBP/DBP, SAT)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Unexpected Intensive Care Unit Admissions | Unexpected Intensive Care Unit Admissions | During ward admission, from moment of arival on ward till discharge or transfer, average of 4 days. | 
| Rapid Response Team Activations | Rapid Response Team Activations | During ward admission, from moment of arival on ward till discharge or transfer, average of 4 days. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of Stay | Length of stay on the ward, ICU and Hospital stay as whole | During ward, ICU and hospital admission, till discharge, transfer to other hospital or death. Average of 5 days. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Early Warning Scores, Continuous Vital Sign Monitoring, Escalation of Care, ICU-Transfer, Deterioration prevention