Avaliação do uso de uma tecnologia Wearable na monitorização de pacientes em enfermaria hospitalar: um estudo observacional

Abstract

Vital signs are measures of body function that reflect patients’ health state and includes respiratory rate, blood pressure, heart rate, and temperature. In hospital wards, these parameters are measured and registered by nursing professionals every 4 hours to monitor and detect possible clinical deterioration. There is still not a consensus of the best method and frequency of monitorization to avoid clinical deterioration, however better monitorization has been associated with better clinical outcomes. Therefore, early detection of clinical deterioration can prevent adverse events, clinical complications and even mortality. Wearable devices allow continuing, non-invasive, monitoring of vital and non-vital signs of patients in all hospital environments, facilitating early detection of deterioration, reducing work overload from nursing staff, reduce patients’ disturbance, and increase mobility. To verify the usability of FitBit inspire 3 wearable devices for measuring vital signs of patients admitted in hospital wards. Longitudinal prospective analytic observational study. We included 54 patients, age equal or higher than 50 years old, that have been admitted to the hospital ward of Medsenior Hospital in Vitoria/ES, for at least 24 hours, without severe clinical state or need for invasive procedures. Those who agreed to participate used a wrist device, model FitBit inspire 3 for 24 hours, no removal allowed during this period. Two nursing staff, morning, and night were responsible for registering vital signs the conventional way, every 6 hours, while the wearable device registered during the 24 hours and sent the data, via Bluetooth, to a cloud platform named Senior Health Mobile. The staff were also to be responsible for registering any adverse event observed with the device relating to battery, water resistance, display, data transfer, and others. All participants, patients, and staff answered the items of the Scale of System Usability (SSU) to evaluate their experience of the ease and likeness of use of the device in hospital wards. The study acquired 20 devices, 15 were used simultaneously, and 5 were reserved for eventual system failure. The use of the wearable was analyzed in 25 patients, 15 women and 10 men, mean age 77,4 years old (SD ± 12.3). The wearable showed low consumption of battery life (mean 28.5%, SD± 2.0), lack of deterioration, system failure or water adverse event after 24 hours of use and there was no microbial development after 72 hours of incubation. Twenty-five patients and 25 nursing staff responded to the SUS scale and showed good acceptability and usability of the wearable Fitbit Inspire 3. The results suggest that FitBit inspire 3 might be a good low-cost alternative to continuing monitoring of hospitalized patients.