Journal article
A controlled trial of electronic automated advisory vital signs monitoring in general hospital wards
Critical care medicine, Vol.40(8), pp.2349-2361
08/01/2012
DOI: 10.1097/CCM.0b013e318255d9a0
PMID: 22809908
Abstract
Objectives: Deteriorating ward patients are at increased risk. Electronic automated advisory vital signs monitors may help identify such patients and improve their outcomes.
Setting: A total of 349 beds, in 12 general wards in ten hospitals in the United States, Europe, and Australia.
Patients: Cohort of 18,305 patients.
Design: Before-and-after controlled trial.
Intervention: We deployed electronic automated advisory vital signs monitors to assist in the acquisition of vital signs and calculation of early warning scores. We assessed their effect on frequency, type, and treatment of rapid response team calls; survival to hospital discharge or to 90 days for rapid response team call patients; overall type and number of serious adverse events and length of hospital stay.
Measurements and Main Results: We studied 9,617 patients before (control) and 8,688 after (intervention) deployment of electronic automated advisory vital signs monitors. Among rapid response team call patients, intervention was associated with an increased proportion of calls secondary to abnormal respiratory vital signs (from 21% to 31%; difference [95% confidence interval] 9.9 [0.1-18.5]; p = .029). Survival immediately after rapid response team treatment and survival to hospital discharge or 90 days increased from 86% to 92% (difference [95% confidence interval] 6.3 [0.0-12.6]; p = .04). Intervention was also associated with a decrease in median length of hospital stay in all patients (unadjusted p < .0001; adjusted p = .09) and more so in U.S. patients (from 3.4 to 3.0 days; unadjusted p < .0001; adjusted ratio [95% confidence interval] 1.03 [1.00-1.06]; p = .026). The time required to complete and record a set of vital signs decreased from 4.1 +/- 1.3 mins to 2.5 +/- 0.5 mins (difference [95% confidence interval] 1.6 [1.4-1.8]; p < .0001).
Conclusions: Deployment of electronic automated advisory vital signs monitors was associated with an improvement in the proportion of rapid response team-calls triggered by respiratory criteria, increased survival of patients receiving rapid response team calls, and decreased time required for vital signs measurement and recording (NCT01197326). (Crit Care Med 2012; 40: 2349-2361)
Details
- Title: Subtitle
- A controlled trial of electronic automated advisory vital signs monitoring in general hospital wards
- Creators
- Rinaldo Bellomo - PhilipsMichael Ackerman - Austin HealthMichael Bailey - University of Rochester Medical CenterRichard Beale - Australian and New Zealand Intensive Care SocietyGreg ClancyValerie Danesh - Orlando Regional Medical CenterAndreas Hvarfner - Lund UniversityEdgar Jimenez - Orlando Regional Medical CenterDavid Konrad - Karolinska University HospitalMichele Lecardo - Karolinska University HospitalKimberly S. PatteeJosephine Ritchie - Norwalk HospitalKathie Sherman - Melrose-Wakefield HospitalPeter Tangkau - Reinier de Graaf HospitalVital Signs to Identify, Target, and Assess Level of Care Study (VITAL Care Study) Investigators
- Resource Type
- Journal article
- Publication Details
- Critical care medicine, Vol.40(8), pp.2349-2361
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/CCM.0b013e318255d9a0
- PMID
- 22809908
- ISSN
- 0090-3493
- eISSN
- 1530-0293
- Number of pages
- 13
- Grant note
- Phillips International
- Language
- English
- Date published
- 08/01/2012
- Academic Unit
- Nursing
- Record Identifier
- 9984548669602771
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