JTCVS Open (Dec 2023)
Remote telemonitoring is associated with improved patient safety and decreased workload of nursesCentral MessagePerspective
Abstract
Objective: There is significant interest in exploring new technologies to improve efficiency and work-life quality for nurses. We aimed to evaluate the impact of a remote video monitoring (RVM) solution that provides continuous in-hospital patient audio-video (AV) monitoring by technicians. Methods: The RVM system that we developed, consisting of 2-way AV communication and a continuous O2 saturation monitoring device, has been deployed in all inpatient units within our hospital network, including 3 acute care hospitals and 2 rehabilitation facilities. Data were collected before and after implementation on safety measures including fall rates and adverse events, along with device utilization and number of escalation events requiring nursing intervention. Nurse job satisfaction was assessed with surveys. Results: Data were collected from April 2020 to May 2022. A total of 2087 patients were monitored at 5 hospital sites. The technicians identified 54,716 safety concerns that required them to intervene remotely and address with the patient. Of these, 46,289 required escalation of nursing staff, who were called to the bedside through the RVM alerting technology. Importantly, 8427 safety concerns were managed solely by the technicians without the need for nursing intervention, resulting in 8427 avoided nursing visits to the bedside. The surveyed nurses reported that the RVM technology provided reassurance that additional support was available to assist them in managing their patients. Patients and their families also expressed high degree of satisfaction. Since implementation, the rates of falls and other adverse events have been reduced, with the greatest impact in patients on high-flow oxygen. Code blue and mortality rates decreased from 7% to 1%. Conclusions: The use of RVM has proven to be a successful innovation at our hospital and has led to improved patient safety. RVM was able to reduce 8427 individual nurse visits to the bedside, allowing nurses to manage the care of patients more effectively while improving both patient and staff satisfaction.
