Abstract
INTRODUCTION:
Vital signs are routinely measured every 6 hours in general hospital wards using a spot-check monitor and typically recorded on paper. Newer monitors can transmit vital signs wirelessly to computerised charting and alerting systems. Research into their effectiveness is usually carried out by capturing vital signs wirelessly in parallel with paper charting. We report our experiences of using paper and wireless acquisition in parallel as part of a research study.
METHODS: The study aimed to acquire a physiological database from patients recovering from cardiac surgery. Patients were asked to wear wireless telemetry monitors throughout their stay on a recovery ward. Ward staff were trained to use Wi-Fi enabled spot-check monitors at the outset. They were asked to record vital signs on paper for clinical use, and electronically for research use, requiring minor workflow additions. Research nurses visited daily to support study patients and assist staff. Vital signs were acquired from 198 patients over 14 months. Two experts transcribed vital signs from paper charts using double data entry.
RESULTS: 372 (6%) out of 6432 vital signs sets were acquired electronically. The proportion acquired electronically decreased over the four quarters of the study duration: 18% (out of 626), 8% (2118), 2% (1867) and 3% (1813). We identified a number of issues contributing to poor monitor usage:1. There was no immediate positive reinforcement for acquiring vital signs electronically since staff did not have access to the electronic charting system.2. Ward staff were mainly encouraged to maintain telemetry monitor usage. They were not encouraged as strongly to maintain high levels of spot-check monitor usage since it was thought this may engender a negative response.3. Staff turnover and use of temporary staff was high. Therefore during the study an increasing number of staff had not received full training on the monitor.4. We did not have a local champion from within the ward staff with adequate time to encourage usage.
CONCLUSION: Engaging clinical staff in research data collection can be difficult. Data collection tasks should be aligned as closely as possible to their existing workflow. Adequate engagement, incentivisation and training are also required. These tasks may require significant resources throughout a study.
METHODS: The study aimed to acquire a physiological database from patients recovering from cardiac surgery. Patients were asked to wear wireless telemetry monitors throughout their stay on a recovery ward. Ward staff were trained to use Wi-Fi enabled spot-check monitors at the outset. They were asked to record vital signs on paper for clinical use, and electronically for research use, requiring minor workflow additions. Research nurses visited daily to support study patients and assist staff. Vital signs were acquired from 198 patients over 14 months. Two experts transcribed vital signs from paper charts using double data entry.
RESULTS: 372 (6%) out of 6432 vital signs sets were acquired electronically. The proportion acquired electronically decreased over the four quarters of the study duration: 18% (out of 626), 8% (2118), 2% (1867) and 3% (1813). We identified a number of issues contributing to poor monitor usage:1. There was no immediate positive reinforcement for acquiring vital signs electronically since staff did not have access to the electronic charting system.2. Ward staff were mainly encouraged to maintain telemetry monitor usage. They were not encouraged as strongly to maintain high levels of spot-check monitor usage since it was thought this may engender a negative response.3. Staff turnover and use of temporary staff was high. Therefore during the study an increasing number of staff had not received full training on the monitor.4. We did not have a local champion from within the ward staff with adequate time to encourage usage.
CONCLUSION: Engaging clinical staff in research data collection can be difficult. Data collection tasks should be aligned as closely as possible to their existing workflow. Adequate engagement, incentivisation and training are also required. These tasks may require significant resources throughout a study.
| Original language | English |
|---|---|
| Title of host publication | MEC Annual Meeting and Bioengineering14 Programme and Abstracts |
| Place of Publication | London |
| Publisher | MECbioeng14, Imperial College London |
| Pages | 62-62 |
| Number of pages | 1 |
| ISBN (Print) | 978-0-9930390-0-3 |
| Publication status | Published - 2014 |
| Event | Medical Engineering Centres Annual Meeting and Bioengineering 14 - Imperial College London, London, United Kingdom Duration: 10 Sept 2014 → 11 Sept 2014 |
Conference
| Conference | Medical Engineering Centres Annual Meeting and Bioengineering 14 |
|---|---|
| Country/Territory | United Kingdom |
| City | London |
| Period | 10/09/2014 → 11/09/2014 |