How monitoring low-acuity patients improves health outcomes

The objective was to facilitate early recognition of deterioration and cue rescue interventions at the earliest possible moment. Notifications were sent to a patient's nurse via pager when monitor values were outside established physiologic limits, with an escalation if there was no response. Q: Were you concerned about a possible increase in alarm monitoring? If so, what did you do to minimize such events? A: The possibility of increased alarms was certainly a concern. To proactively address this issue, we lowered thresholds and widened ranges consistent with the work done at Dartmouth. We have found that this decreased false positives, and yet still identified those at risk. Q: What was the reaction of VUMC's staff to continuous monitoring? A: When we surveyed nurses, we heard a lot of negative feedback, like there are too many false positives when a patient uses their hands, the finger probe is uncomfortable, the probe interferes with personal hygiene, patients don't see the necessity of continuous monitoring, monitoring impedes ambulation and inhibits mobility, and monitoring makes rooms too crowded. And yet, we met resistance when we tried to remove monitors from the pilot locations. We realized the survey told us more about the kind of survey we had conducted (for example, negatively worded survey questions were predominant) and what could be done to successfully implement the system rather than about the effectiveness of monitoring. Q: What showed you and VUMC nur...
Source: hospital impact - Category: Health Managers Authors: Source Type: blogs