scholarly journals Nurse anesthetists’ experiences using smart glasses to monitor patients’ vital signs during anesthesia care: A qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250122
Author(s):  
Charlotte Romare ◽  
Per Enlöf ◽  
Peter Anderberg ◽  
Pether Jildenstål ◽  
Johan Sanmartin Berglund ◽  
...  
Keyword(s):  
Continuous Monitoring ◽  
Vital Signs ◽  
Nurse Anesthetists ◽  
Anesthesia Care ◽  
Nurse Anesthetist ◽  
Structured Interviews ◽  
Smart Glasses ◽  
Great Responsibility ◽  
Safe Anesthesia ◽  
Clinical Anesthesia

Purpose To describe nurse anesthetists’ experiences using smart glasses to monitor patients’ vital signs during anesthesia care. Methods Data was collected through individual semi-structured interviews with seven nurse anesthetists who had used smart glasses, with a customized application for monitoring vital signs, during clinical anesthesia care. Data was analyzed using thematic content analysis. Results An overarching theme became evident during analysis; Facing and embracing responsibility. Being a nurse anesthetist entails a great responsibility, and the participants demonstrated that they shouldered this responsibility with pride. The theme was divided in two sub-themes. The first of these, A new way of working, comprised the categories Adoption and Utility. This involved incorporating smart glasses into existing routines in order to provide safe anesthesia care. The second sub-theme, Encountering side effects, consisted of the categories Obstacles and Personal affect. This sub-theme concerned the possibility to use smart glasses as intended, as well as the affect on nurse anesthetists as users. Conclusion Smart glasses improved access to vital signs and enabled continuous monitoring regardless of location. Continued development and improvement, both in terms of the application software and the hardware, are necessary for smart glasses to meet nurse anesthetists’ needs in clinical practice.

scholarly journals Intraoperative Transitions of Anesthesia Care and Postoperative Adverse Outcomes

2014 ◽  
Vol 121 (4) ◽  
pp. 695-706 ◽  
Author(s):  
Leif Saager ◽  
Brian D. Hesler ◽  
Jing You ◽  
Alparslan Turan ◽  
Edward J. Mascha ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Odds Ratio ◽  
Care Transitions ◽  
Cleveland Clinic ◽  
Nurse Anesthetists ◽  
Adverse Outcomes ◽  
Anesthesia Care ◽  
Nurse Anesthetist ◽  
Intraoperative Care ◽  
Anesthesia Providers

Abstract Background: Transfers of patient care and responsibility among caregivers, “handovers,” are common. Whether handovers worsen patient outcome remains unclear. The authors tested the hypothesis that intraoperative care transitions among anesthesia providers are associated with postoperative complications. Methods: From the records of 138,932 adult Cleveland Clinic (Cleveland, Ohio) surgical patients, the authors assessed the association between total number of anesthesia handovers during a case and an adjusted collapsed composite of in-hospital mortality and major morbidities using multivariable logistic regression. Results: Anesthesia care transitions were significantly associated with higher odds of experiencing any major in-hospital mortality/morbidity (incidence of 8.8, 11.6, 14.2, 17.0, and 21.2% for patients with 0, 1, 2, 3, and ≥4 transitions; odds ratio 1.08 [95% CI, 1.05 to 1.10] for an increase of 1 transition category, P < 0.001). Care transitions among attending anesthesiologists and residents or nurse anesthetists were similarly associated with harm (odds ratio 1.07 [98.3% CI, 1.03 to 1.12] for attending [incidence of 9.4, 13.9, 17.4, and 21.5% for patients with 0, 1, 2, and ≥3 transitions] and 1.07 [1.04 to 1.11] for residents or nurses [incidence of 9.4, 13.0, 15.4, and 21.2% for patients with 0, 1, 2, and ≥3 transitions], both P < 0.001). There was no difference between matched resident only (8.5%) and nurse anesthetist only (8.8%) cases on the collapsed composite outcome (odds ratio, 1.00 [98.3%, 0.93 to 1.07]; P = 0.92). Conclusion: Intraoperative anesthesia care transitions are strongly associated with worse outcomes, with a similar effect size for attendings, residents, and nurse anesthetists.

scholarly journals Anesthesia Care Team Composition and Surgical Outcomes

2018 ◽  
Vol 129 (4) ◽  
pp. 700-709 ◽  
Author(s):  
Eric C. Sun ◽  
Thomas R. Miller ◽  
Jasmin Moshfegh ◽  
Laurence C. Baker
Keyword(s):  
Length Of Stay ◽  
The United States ◽  
Nurse Anesthetists ◽  
Care Team ◽  
Perioperative Outcomes ◽  
Anesthesia Care ◽  
Team Composition ◽  
Nurse Anesthetist ◽  
Medical Spending ◽  
Publicly Insured

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background In the United States, anesthesia care can be provided by an anesthesia care team consisting of nonphysician providers (nurse anesthetists and anesthesiologist assistants) working under the supervision of a physician anesthesiologist. Nurse anesthetists may practice nationwide, whereas anesthesiologist assistants are restricted to 16 states. To inform policies concerning the expanded use of anesthesiologist assistants, the authors examined whether the specific anesthesia care team composition (physician anesthesiologist plus nurse anesthetist or anesthesiologist assistant) was associated with differences in perioperative outcomes. Methods A retrospective analysis was performed of national claims data for 443,098 publicly insured elderly (ages 65 to 89 yr) patients who underwent inpatient surgery between January 1, 2004, and December 31, 2011. The differences in inpatient mortality, spending, and length of stay between cases where an anesthesiologist supervised an anesthesiologist assistant compared to cases where an anesthesiologist supervised a nurse anesthetist were estimated. The approach used a quasirandomization technique known as instrumental variables to reduce confounding. Results The adjusted mortality for care teams with anesthesiologist assistants was 1.6% (95% CI, 1.4 to 1.8) versus 1.7% for care teams with nurse anesthetists (95% CI, 1.7 to 1.7; difference −0.08; 95% CI, −0.3 to 0.1; P = 0.47). Compared to care teams with nurse anesthetists, care teams with anesthesiologist assistants were associated with non–statistically significant decreases in length of stay (−0.009 days; 95% CI, −0.1 to 0.1; P = 0.89) and medical spending (−$56; 95% CI, −334 to 223; P = 0.70). Conclusions The specific composition of the anesthesia care team was not associated with any significant differences in mortality, length of stay, or inpatient spending.

scholarly journals Smart Glasses for Caring Situations in Complex Care Environments: Scoping Review

10.2196/16055 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e16055
Author(s):  
Charlotte Romare ◽  
Lisa Skär
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Scoping Review ◽  
Health Care Professionals ◽  
Qualitative Content Analysis ◽  
High Tech ◽  
Anesthesia Care ◽  
Complex Care ◽  
Smart Glasses

Background Anesthesia departments and intensive care units represent two advanced, high-tech, and complex care environments. Health care in those environments involves different types of technology to provide safe, high-quality care. Smart glasses have previously been used in different health care settings and have been suggested to assist health care professionals in numerous areas. However, smart glasses in the complex contexts of anesthesia care and intensive care are new and innovative. An overview of existing research related to these contexts is needed before implementing smart glasses into complex care environments. Objective The aim of this study was to highlight potential benefits and limitations with health care professionals' use of smart glasses in situations occurring in complex care environments. Methods A scoping review with six steps was conducted to fulfill the objective. Database searches were conducted in PubMed and Scopus; original articles about health care professionals’ use of smart glasses in complex care environments and/or situations occurring in those environments were included. The searches yielded a total of 20 articles that were included in the review. Results Three categories were created during the qualitative content analysis: (1) smart glasses as a versatile tool that offers opportunities and challenges, (2) smart glasses entail positive and negative impacts on health care professionals, and (3) smart glasses' quality of use provides facilities and leaves room for improvement. Smart glasses were found to be both a helpful tool and a hindrance in caring situations that might occur in complex care environments. This review provides an increased understanding about different situations where smart glasses might be used by health care professionals in clinical practice in anesthesia care and intensive care; however, research about smart glasses in clinical complex care environments is limited. Conclusions Thoughtful implementation and improved hardware are needed to meet health care professionals’ needs. New technology brings challenges; more research is required to elucidate how smart glasses affect patient safety, health care professionals, and quality of care in complex care environments.

scholarly journals Indications of admitting patients in internal ICU and the rate of mortality in Emam Khomeini hospital in 2013

2019 ◽  
Vol 6 (6) ◽  
pp. 2335
Author(s):  
Hasan Ghobadi ◽  
Shahram Habibzadeh ◽  
Bita Shahbazzadegan ◽  
Mohsen Mirzanezhadasl ◽  
Mahsa Kamranimoghaddam
Keyword(s):  
Mortality Rate ◽  
Continuous Monitoring ◽  
Good Condition ◽  
Vital Signs ◽  
The Public ◽  
Special Services ◽  
Disease Prognosis ◽  
Significant Difference ◽  
The Mean ◽  
End Stage

Background: ICU is the costly part of the hospital that has functional approach for patients who have reversible conditions so it needs mechanical ventilation and other special services. Some patients are not really in need of special care only the continuous monitoring of vital signs needs of the public sector. Patients with good condition or End-Stage were not candidate to admitting in ICU. The aim of this study was to evaluate indications of admitting patients in internal ICU and the rate of mortality in Emam Khomeini hospital in 2013.Methods: The study was conducted retrospectively evaluated the records of patients hospitalized in ICU and disease prognosis and treatment of disease and APACHE2 criteria was analyses.Results: The mean age of patients in the study was 61.05±19.81. Of 118 patients, 70 (59.3%) survived and 48 (40.7%) patients died. APACHE2 mean in the study was 21.46±7.5. GCS average was 9.83±4.27. There was correlation between mortality of patients and type of disease. In this study in APACHE2 score between 25-29 and >35 in mortality rate we are higher than standard average and in 10-14 and 20-24 we are lower than standard average.Conclusions: This study shows that GCS is not a good measure for the evaluation of patients hospitalized in internal ICU. In the present study, patients with higher APACHE2 score of 35 died. That show hospitalization that patient in ICU has no difference in the prognosis of them. As regards mortality rate in ICU patients in this study has no significant difference with predicted APACHE values, indications of ICU admition in Emam Khomeini hospital observed exactly.

scholarly journals Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review

10.2196/18636 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e18636 ◽  
Author(s):  
Jobbe P L Leenen ◽  
Crista Leerentveld ◽  
Joris D van Dijk ◽  
Henderik L van Westreenen ◽  
Lisette Schoonhoven ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Clinical Outcomes ◽  
Health Care Professionals ◽  
Continuous Monitoring ◽  
Vital Signs ◽  
Current Evidence ◽  
Cochrane Central Register ◽  
Wireless Devices

Background Continuous monitoring of vital signs by using wearable wireless devices may allow for timely detection of clinical deterioration in patients in general wards in comparison to detection by standard intermittent vital signs measurements. A large number of studies on many different wearable devices have been reported in recent years, but a systematic review is not yet available to date. Objective The aim of this study was to provide a systematic review for health care professionals regarding the current evidence about the validation, feasibility, clinical outcomes, and costs of wearable wireless devices for continuous monitoring of vital signs. Methods A systematic and comprehensive search was performed using PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from January 2009 to September 2019 for studies that evaluated wearable wireless devices for continuous monitoring of vital signs in adults. Outcomes were structured by validation, feasibility, clinical outcomes, and costs. Risk of bias was determined by using the Mixed Methods Appraisal Tool, quality assessment of diagnostic accuracy studies 2nd edition, or quality of health economic studies tool. Results In this review, 27 studies evaluating 13 different wearable wireless devices were included. These studies predominantly evaluated the validation or the feasibility outcomes of these devices. Only a few studies reported the clinical outcomes with these devices and they did not report a significantly better clinical outcome than the standard tools used for measuring vital signs. Cost outcomes were not reported in any study. The quality of the included studies was predominantly rated as low or moderate. Conclusions Wearable wireless continuous monitoring devices are mostly still in the clinical validation and feasibility testing phases. To date, there are no high quality large well-controlled studies of wearable wireless devices available that show a significant clinical benefit or cost-effectiveness. Such studies are needed to help health care professionals and administrators in their decision making regarding implementation of these devices on a large scale in clinical practice or in-home monitoring.

Intelligent Bed Sheet Detects Respiratory Patterns

2018 ◽  
Vol 62 (1) ◽  
pp. 1177-1181 ◽  
Author(s):  
Laura Nicholson ◽  
Olivia Lin ◽  
Edward Shim
Keyword(s):  
Continuous Monitoring ◽  
Resource Constraints ◽  
New Technology ◽  
Vital Signs ◽  
The Body ◽  
Second Phase ◽  
Age In Place ◽  
Sensor Validation ◽  
Health Canada ◽  
Respiratory Conditions

A new technology using an intelligent bed sheet made of fabric sensors is described as a novel advancement that supports wireless and continuous monitoring of vital signs without requiring wire attachments to the body. The intelligent bed sheet developed by Studio 1 Labs Inc. (Studio 1 Labs), can be used to support three distinct groups: i) healthcare institutions with human resource constraints, ii) caregivers who provide care for seniors, infants and children at home, and iii) independent seniors who prefer to age in place. This article describes two complementary research phases using the intelligent bed sheet to detect heart rate, respiratory rate, and respiratory effort. The first phase explores sensor validation from the intelligent bed sheet with preset respiratory conditions from high technology mannequins. The second phase involves a use case with healthy young adults comparing between physiological signals from the bed sheet with standard nursing protocols of manual counts and a pulse oximeter approved by Health Canada.

Review: Continuous Monitoring to Detect Failure to Rescue in Adult Postoperative Inpatients

2018 ◽  
Vol 52 (4) ◽  
pp. 281-287 ◽  
Author(s):  
Sue Carol Verrillo ◽  
Bradford D. Winters
Keyword(s):  
Vital Sign ◽  
Sleep Disordered Breathing ◽  
Continuous Monitoring ◽  
Vital Signs ◽  
Clinical Deterioration ◽  
Failure To Rescue ◽  
Contributing Factors ◽  
Unexpected Death ◽  
Practice Model ◽  
Preventable Complication

Abstract Failure to rescue, or the unexpected death of a patient due to a preventable complication, is a nationally documented problem with numerous and multifaceted contributing factors. These factors include the frequency and method of collecting vital sign data, response to abnormal vital signs, and delays in the escalation of care for general ward patients who are showing signs of clinical deterioration. Patients' clinical deterioration can be complicated by concurrent secondary factors, including opioid abuse/dependence, being uninsured, or having sleep-disordered breathing. Using the Johns Hopkins Nursing Evidence-Based Practice Model, this integrative review synthesizes 43 research and nonresearch sources of evidence. Published between 2001 and 2017, these sources of evidence focus on failure to rescue, the multifaceted contributing factors to failure to rescue, and how continuous vital sign monitoring could ameliorate failure to rescue and its causes. Recommendations from the sources of evidence have been divided into system, structural, or technological categories.

scholarly journals A dataset of clinically recorded radar vital signs with synchronised reference sensor signals

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Sven Schellenberger ◽  
Kilin Shi ◽  
Tobias Steigleder ◽  
Anke Malessa ◽  
Fabian Michler ◽  
...  
Keyword(s):  
Continuous Monitoring ◽  
Continuous Wave ◽  
Vital Signs ◽  
Radar System ◽  
Tilt Table ◽  
Non Invasive ◽  
Impedance Cardiogram ◽  
Wave Radar ◽  
Reference Device ◽  
Sensor Signals

Abstract Using Radar it is possible to measure vital signs through clothing or a mattress from the distance. This allows for a very comfortable way of continuous monitoring in hospitals or home environments. The dataset presented in this article consists of 24 h of synchronised data from a radar and a reference device. The implemented continuous wave radar system is based on the Six-Port technology and operates at 24 GHz in the ISM band. The reference device simultaneously measures electrocardiogram, impedance cardiogram and non-invasive continuous blood pressure. 30 healthy subjects were measured by physicians according to a predefined protocol. The radar was focused on the chest while the subjects were lying on a tilt table wired to the reference monitoring device. In this manner five scenarios were conducted, the majority of them aimed to trigger hemodynamics and the autonomic nervous system of the subjects. Using the database, algorithms for respiratory or cardiovascular analysis can be developed and a better understanding of the characteristics of the radar-recorded vital signs can be gained.

scholarly journals Evaluation of tactile cues for simulated patients’ status under high and low workload

2019 ◽  
Vol 63 (1) ◽  
pp. 658-662 ◽  
Author(s):  
Nuphar Katzman ◽  
May Gellert ◽  
Joseph J. Schlesinger ◽  
Tal Oron-Gilad ◽  
Jeremy R. Cooperstock ◽  
...  
Keyword(s):  
Undergraduate Students ◽  
Continuous Monitoring ◽  
Vital Signs ◽  
Simulated Patients ◽  
Clinical Environment ◽  
Physiological Conditions ◽  
Visual Color ◽  
Physiological Information ◽  
Tactile Cues ◽  
Series Of Experiments

The intensive care unit (ICU) is one of the most complex areas in hospital care, as patients require continuous monitoring by physicians and nurses. Currently, clinicians are informed about the patients’ physiological conditions through visual color-coded signals and auditory alarms. Previous studies have shown that vibrotactile cues can be used to inform clinicians of a patient’s vital signs status, either in a unisensory or multisensory alarm scheme. We present the results of the first in a series of experiments devoted to examining the feasibility to use tactile cues to convey detailed physiological information about more than one patient, rendered through a lower-leg tactile interface. The current experiment utilized a simulated clinical environment with 14 undergraduate students. Participants were required to interpret information delivered by the tactile interface, for two different patients, while they performed a continuous cognitively demanding task. Results indicate that under such conditions, it is possible to deliver critical information with a successful interpretation rate of approximately 85% but not without cost to the continuous demanding task. Future experiments should evaluate more tactile patterns in order to increase their interpretation success rate, and evaluate the use of these tactile cues with clinicians.

Longitudinal Analysis of Continuous Pulse Oximetry as Prognostic Factor in Neonatal Respiratory Distress

2020 ◽  
Author(s):  
Gonzalo Solís-García ◽  
Elena Maderuelo-Rodríguez ◽  
Teresa Perez-Pérez ◽  
Laura Torres-Soblechero ◽  
Ana Gutiérrez-Vélez ◽  
...  
Keyword(s):  
Heart Rate ◽  
Intensive Care ◽  
Respiratory Distress ◽  
Oxygen Saturation ◽  
Continuous Monitoring ◽  
Vital Signs ◽  
Epidemiological Data ◽  
Monitoring Data ◽  
Joint Models ◽  
Neonatal Icu

Objective Analysis of longitudinal data can provide neonatologists with tools that can help predict clinical deterioration and improve outcomes. The aim of this study is to analyze continuous monitoring data in newborns, using vital signs to develop predictive models for intensive care admission and time to discharge. Study Design We conducted a retrospective cohort study, including term and preterm newborns with respiratory distress patients admitted to the neonatal ward. Clinical and epidemiological data, as well as mean heart rate and saturation, at every minute for the first 12 hours of admission were collected. Multivariate mixed, survival and joint models were developed. Results A total of 56,377 heart rate and 56,412 oxygen saturation data were analyzed from 80 admitted patients. Of them, 73 were discharged home and 7 required transfer to the intensive care unit (ICU). Longitudinal evolution of heart rate (p < 0.01) and oxygen saturation (p = 0.01) were associated with time to discharge, as well as birth weight (p < 0.01) and type of delivery (p < 0.01). Longitudinal heart rate evolution (p < 0.01) and fraction of inspired oxygen at admission at the ward (p < 0.01) predicted neonatal ICU (NICU) admission. Conclusion Longitudinal evolution of heart rate can help predict time to transfer to intensive care, and both heart rate and oxygen saturation can help predict time to discharge. Analysis of continuous monitoring data in patients admitted to neonatal wards provides useful tools to stratify risks and helps in taking medical decisions. Key Points

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