Overvåking av vitale parametere i sykehus : En sammenligning av manuelle og elektroniske overvåkingssystemer

Abstract

Adverse events can be avoided by timely recognition of derangements in vital signs. Sørlandet Hospital HF (SSHF) has implemented an Early Warning Score System named "TILT"; 2Early identification of life-threatening conditions”. In 2017 SSHF started a project that tested wireless sensors for continuous monitoring of vital signs on wards. Patients were monitored by sensors and vital signs were also measured by traditional means during the project period. The aim of this study was to examine compliance with the vital signs monitoring protocol, and to examine the benefits of an electronic system. The following questions have been explored: "To what extent is there compliance with the vital signs monitoring protocol in the medical department SSHF?" "To what extent can the use eTILT solve the challenges associated with mTILT in SSHF?" A quantitative observational study has been conducted. Journals have been reviewed. The sample consisted of the records of all patients who were monitored by wireless sensors during the project period. The study showed that 68% of the observation sets were recorded on time. In 11% of the observation sets, wrong aggregate score was calculated. Vital signs were measured infrequently during nighttime. Only 83% of the observation sets were complete. Electronic TILT was associated with significantly more observation sets than manual TILT. All observation sets were incomplete. The sensors that measured temperature, respiratory rate and pulse delivered measurements in 3.98%, 98.8% and 99.3% of the observation sets. The study showed only partly compliance with the vital signs monitoring protocol. The use of wireless sensors has the potential of improving patient monitoring. Nevertheless, the sensors do not measure vital signs as frequent as expected and the system does not provide automated electronic alerts. These factors should be improved before the system can be used in a clinical setting. Keywords: Early Warning Score, TILT, Clinical Decision Support Systems, Early Warning System, Sensor Technology, monitoring vital signs