Authors: Songthawornpong et al.
Journal: Patient Safety published: 2023
Summary:
This feasibility study evaluated whether continuous vital sign monitoring could be performed at home after hospital discharge in patients admitted with acute medical illness. The goal was to determine whether home monitoring could support earlier discharge while still allowing clinicians to identify concerning physiologic changes after patients leave the hospital.
The study included patients who were being discharged after admission for acute medical disease. Patients wore three wireless monitoring devices at home for four days: a chest patch to measure heart rate and respiratory rate, a pulse oximeter, and a blood pressure monitor.
Monitoring was started in 80 patients. Of these, 69 patients had at least 6 hours of monitoring time after discharge and were included in the analysis. The chest patch performed best, collecting heart rate and respiratory rate data for 88% of the monitored time. The pulse oximeter collected data for 60% of monitored time, while the blood pressure monitor collected data for only 32% of monitored time.
The study found that abnormal vital signs were common after discharge. Oxygen desaturation below 88% occurred in 92% of patients, and desaturation below 85% occurred in 83% of patients. Tachypnea, defined as respiratory rate greater than 24 breaths per minute, occurred in 61% of patients. Tachycardia greater than 130 beats per minute lasting at least 30 minutes occurred in 28% of patients.
Why this matters:
This study suggests that continuous home monitoring after discharge is feasible, especially for heart rate and respiratory rate using a chest patch. It also shows that significant oxygen desaturation and other abnormal vital signs may be common after discharge, even in patients considered ready to leave the hospital.
Take-home point:
Continuous vital sign monitoring after hospital discharge appears feasible, but the reliability of data collection varies by device. The frequent detection of oxygen desaturation raises important questions about how clinicians should respond to abnormal home-monitoring data.
Thank you to Patient Safety for publishing this article and allowing us to summarize it.