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Rationale: Monitoring patients' vital signs is done to detect clinical deterioration. For this, the MEWS, a scoring list comprising seven vital signs measured by nursing staff, is used. Although the MEWS provides relevant data on patients' health status, the interval measurements may not capture early deterioration of vital signs, especially during the night. As a result, unsafe situations may occur such as periods of low oxygen saturation and cardiac arrhythmias, which are known to complicate postoperative course. Besides, this way of measuring vital signs may be stressful for patients and disturbs patients' sleep. New technology such as ViSi Mobile and HealthPatch allows for remote continuous monitoring of vital signs using wearable devices transmitting relevant data to nurses and clinicians. With this, the investigators think that clinical deterioration may be detected in an early phase and reduce nurse work load and patient distress.
Objective: to investigate the feasibility of wearable devices on the general ward.
Study design: feasibility study.
Study population: adult patients hospitalized on the internal medicine ward and adult postoperative patients on the surgical ward.
Intervention: patients in the intervention groups will be randomized in one of the two groups. Patients in the group 1 will wear ViSi Mobile; patients in group 2 will wear the HealthPatch. Wearable devices will be worn for at least three days. Regular MEWS measurements take place at usual time points.
Main study parameters/endpoints: Evaluation with patient and care givers (primary outcome measure), MEWS calculations, time between alarm (continuous data) and next regular MEWS measurement (nurse), intervention by nurse after alarm, admission to ICU, complications, side effects of devices, STAI scores, and PCS scores will be documented.
Nature and extent of the burden and risks associated with participation, benefit and group relatedness: Patients will wear one device for at least three days. Devices can be uncomfortable by being heavy or the patches can start itching. More measurements by nurses can take place when indicated, for example after alarms. The participating patients will fill out the STAI on daily basis and the PCS on the last day of hospitalization. Both questionnaires will take a few minutes to complete. Patients could benefit from early detection of clinical deterioration and early corrective interventions or ICU admissions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group | No Intervention | Patients with regular measurements by nurses only (Modified Early Warning Score (MEWS)) | |
| HealthPatch (Intervention) | Experimental | Patients with HealthPatch and regular MEWS measurements |
|
| ViSi Mobile (Intervention) | Experimental | Patients with ViSi Mobile and regular MEWS measurements |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HealthPatch | Device | The HealthPatch (Vital Connect) is a wireless patch and continuously measures single-lead ECG, heart rate, respiratory rate, stress, skin temperature, body posture and steps |
| Measure | Description | Time Frame |
|---|---|---|
| Expectations & experiences of patients | Interviews of 15-20 minutes with patients after 2-3 days wearing a device or control group | 2-3 days after informed consent |
| Expectations & experiences of care givers | Interviews with nurses of 15-20 minutes at the end of the study. Estimated amount of 6 nurses | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| MEWS scores based on continuous data and data measured by nurses | 3 times a day, up to three days. | |
| Amount of alarms by HealthPatch or ViSi Mobile | during 2-3 days when the patient wears a device |
| Measure | Description | Time Frame |
|---|---|---|
| Gender | Extraction from EHR | On day 1 when patients participates in the study |
| Age | Extraction from EHR | On day 1 when patients participates in the study |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Harry van Goor, MD, PhD, FRCS | Radboud University Medical Center | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32519972 | Derived | Weenk M, Bredie SJ, Koeneman M, Hesselink G, van Goor H, van de Belt TH. Continuous Monitoring of Vital Signs in the General Ward Using Wearable Devices: Randomized Controlled Trial. J Med Internet Res. 2020 Jun 10;22(6):e15471. doi: 10.2196/15471. |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Sep 1, 2020 | |
| Reset | Sep 24, 2020 | |
| Release | Nov 2, 2020 | |
| Reset | Nov 25, 2020 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Sep 1, 2020 | Sep 24, 2020 | |||
| Nov 2, 2020 |
| ID | Term |
|---|---|
| D021441 | Carcinoma, Pancreatic Ductal |
| D015179 | Colorectal Neoplasms |
| D001168 | Arthritis |
| D006973 | Hypertension |
| D018805 | Sepsis |
| ID | Term |
|---|---|
| D044584 | Carcinoma, Ductal |
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
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| ViSi Mobile | Device | ViSi Mobile (Sotera Wireless) is wireless device that is able to continuously measure all important vital parameters: ECG, heart rate, oxygen saturation, blood pressure, respiratory rate and skin temperature. |
|
| Time between alarm (continuous data) and next regular MEWS measurement (nurse) | during 2-3 days when the patient wears a device |
| Amount of extra MEWS measurements by nurses due to alarms | during 2-3 days when the patient wears a device |
| Admission to ICU (yes/no) | during 2-3 days when the patient participates in this study |
| Duration of ICU hospitalization in days | during 2-3 days when the patient participates in this study |
| Complications caused by disease or surgical procedure | during 2-3 days when the patient participates in this study |
| Adverse events caused by devices | E.g. Itch or redness | during 2-3 days when the patient wears a device |
| Technical failures of devices (artifacts: a period longer than 1 minute the device does not measure vital parameters) | during 2-3 days when the patient wears a device |
| Outcomes of the State Trait Anxiety Inventory (STAI) | Once a day during the 2-3 days the patient participantes in this study |
| Outcomes of the Pain Catastrophizing Scale (PCS) | On day 2 or 3 when patients participates in the study |
| System usability Scale | 1 year |
| Diagnosis | Extraction from EHR | On day 1 when patients participates in the study |
| Performed surgical procedure | Extraction from EHR | On day 1 when patients participates in the study |
| Nov 25, 2020 |
| D009370 |
| Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D018299 | Neoplasms, Ductal, Lobular, and Medullary |
| D010190 | Pancreatic Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D004701 | Endocrine Gland Neoplasms |
| D004066 | Digestive System Diseases |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D007239 | Infections |
| D018746 | Systemic Inflammatory Response Syndrome |
| D007249 | Inflammation |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |