St. George’s University Hospitals NHS Foundation Trust was successful in their nursing technology bid for £1,000,000 last year to purchase integrated vital signs monitors (iVSM) which interface directly with the EMR.
The integration is made possible with CareAware VitalsLink™, a mobile vital signs device solution. The Cerner CareAware VitalsLink solution is a first of type in the UK and offers a technology to help the Trust support the delivery of acute patient care.
Why electronic observations?
Hogan et al (2012)1 calculated that up to 5.2% of deaths in hospital are preventable, with inadequate clinical monitoring the biggest contributor to unnecessary deaths. Therefore the Royal College of Physicians recommend implementation of a National Early Warning System (nEWS)2 to reduce patient risk.
Patient and staff safety sits at the heart of everything we do at St. George’s. The benefits of using the monitors are multitude. They include:
- Wireless connection which sends patient observations and their nEWS score directly to their medical record in real-time
- Displays nEWS score at the bedside with visual prompt for the required escalation
- Eliminates the need to transcribe results – saving time and transcription errors
- Results immediately available to clinicians across the Trust
- Limits the need for charting observations and the nEWS at the computers on wheels
- Can improve the recording of complete sets of observations and correct scoring the EWS.
The monitors are currently being piloted in St George’s renal ward before roll out to other areas within the Trust. The IT team worked in collaboration with the Consultant Nurse for Critical Care, medical physics, Cerner Corporation and Welch Allyn Corporation to develop a monitor configuration that is bespoke to St. George.
The iVSMs uses CareAware VitalsLink to feed results into the patient record in a matter of seconds.
The feedback from staff is that the wireless monitors are simple to use, and make the observation rounds much easier than transcribing results onto paper or to a computer on wheels.
Health Care Assistant Paul Ford said:
“The integrated Vital Signs Monitors are a more efficient and effective way of checking a patient’s EWS score. They are easy to use, faster and more reliable at recording blood pressure and oxygen saturation than the old machines. Some of the patients have recognised the new technology but on the whole the new monitors haven’t really affected the patients except for having to scan their barcodes. I would recommend the new monitors as they help to streamline the process of taking patients observations.”
Thankfully gone are the days of writing patient observations on scrubs or scraps of paper!
This blog post was written by Liz Powell, IT Project Manager, Jonathan Silver, Clinical Scientist and Deborah Dawson, Consultant Nurse Critical Care at St. George’s University Hospital.
Staff from St George’s held a successful webinar on Tuesday 22 September to provide their insights into automating the charting of routine patient observations and Early Warning Scores to our Cerner electronic medical record (EMR). Leading the webinar was Jonathan Silver, Clinical Scientist, Medical Physics and Clinical Engineering; Deborah Dawson, Critical Care Nurse Consultant; and Liz Powell, IT Project Manager. Around 126 people from across Europe registered to listen to their experiences of applying for funding, configuring and deploying integrated vital signs monitors. People on the webinar ranged from clinicians from other hospitals to a director of a care of home.Listeners asked some challenging questions covering training, deployment, connectivity and what was learnt during the project. Feedback was positive and a recording of the webinar is available here.
1) Helen Hogan, Frances Healey, Graham Neale, Richard Thomson, Charles Vincent, Nick Black, Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review study, BMJ Quality & Safety (2012)
2) Royal College of Physicians (2012) National Early Warning Score (NEWS) Standardising the assessment of acute-illness severity in the NHS Report of a working party July 2012