Near real-time continuous remote monitoring of vital signs of patients during administration of medication at home

Master thesis (2023)

Authors

M.A.R. van Well Mechanical Engineering

Contributors

Mark Mulder Erasmus MC (supervisor 1)
Martin van Hagen Erasmus MC (supervisor 2)
Faculty
Mechanical Engineering
Copyright: © 2023 Marleen van Well
Telemedicine Telemonitoring Remote monitoring
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Published Date

16-05-2023

Language

English

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Faculty

Mechanical Engineering

Abstract

Introduction
To cope with the decreasing availability of healthcare personnel, we are in need of a national (and global) transition to make the healthcare system sustainable for the future. Administration of intravenous immunoglobulins (IVIg) at home for patients with immunodeficiencies is an example of a therapy that currently requires a significant amount of nursing staff in relation to the number of patients receiving the treatment. Near real-time continuous remote monitoring (NRCRM) of vital signs of these patients during administration could potentially offer a solution by enabling nurses to treat the same number of patients with fewer staff members. The goal of this pilot study is to test monitoring system functionality, evaluate user experiences and identify challenges and bottlenecks of NRCRM of vital signs of patients during administration of IVIg at home.

Methods
Patients from the department of immunology at Erasmus MC who receive IVIg at home were evaluated for inclusion. During administration, their vital signs were monitored remotely in addition to the usual monitoring procedure performed by the home nurse. Raw data of the vital signs, in combination with an alarm template and observations during administration at home, were used to assess system functionality. User experience was evaluated using custom-made questionnaires. Challenges and bottlenecks for further implementation were identified during execution of the study protocol.

Results
No-data alarms in this study yield an alarm burden of 10.9 ± 4.8 (mean ± SD) alarms per patient per hour with a duration of alarms of 2min59sec ± 13min38sec (mean ± SD).
Threshold alarms in this study yield an alarm burden of 17.1 ± 15.1 (mean ± SD) alarms per patient per hour with a duration of 1min12sec ± 3min (mean ± SD).
Attitudes of both patients and nurses towards the transition to NRCRM are mixed. Most concerns exist around patient safety. 30 challenges and bottlenecks in the transition are identified.

Conclusion
This thesis provides an overview of the actions that need to be taken to overcome associated challenges and bottlenecks. Also, suggestions for implementation were presented. Besides the practical and safety aspect, a challenge lies in addressing the negative attitudes of nurses and patients to ensure smooth adoption.