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持续远程生命体征监测是否能减少对疑似新冠肺炎患者的访视次数?

2021-10-15 小文子 MedSci原创

新冠肺炎流行期间持续生命体征监测对疑似COVID-19患者的就诊次数、获取生命体征的就诊次数以及个人防护设备使用数量的影响。

新冠肺炎流行期间,即使使用适当的防护设备,也建议尽可能减少确诊或疑似感染患者的近距离停留的时间,以减少病毒暴露量,从而降低传播风险。医务人员希望限制与患者近距离接触的时间,以降低疾病传播的风险,但同时希望对突发性缺氧性呼吸衰竭保持警惕。一个解决方案是持续远程生命体征监测。因无线传输和远程访问患者实时生命体征数据的可能性,无论是在家中还是在医疗机构,连续监测是对新冠肺炎患者常规监测的有价值补充。

发表在International Journal of Nursing Studies杂志的一篇文章评估新冠肺炎流行期间持续生命体征监测对疑似COVID-19患者的就诊次数、获取生命体征的就诊次数以及个人防护设备使用数量的影响。研究假设,持续监测将减少主要用于获取生命体征和总就诊次数,从而减少个人防护设备的使用数量。

研究人员在荷兰一家三级医院对疑似COVID-19患者进行自身前后对照研究。观察者观察医院工作人员在白班、晚班和夜班期间的情况,记录病房访视和个人防护设备的使用情况。11天后,应用可穿戴式生命体征连续监测。应用间断时间序列分析评价连续监测对患者访视次数、获取生命体征的访视(改良预警评分访视)和使用个人防护设备量的影响。

研究持续45天,观察86个班次。每次轮班期间,观察六个房间。共记录2347次对患者访视。采用持续生命体征监测后,患者访视次数的斜率系数无变化(B -0.003,95%CI -0.022/0.016)改良预警评分访视次数和个人防护设备使用量的斜率系数也无变化(B -0.002,95%CI -0.021/0.017和B 0.046,95%CI -0.008/0.099)。研究期间,改良预警评分访视次数显示下降,但这种下降不受干预的影响。与白班相比,晚班和夜班与患者就诊较少相关。

结果显示,在普通病房对疑似COVID-19患者实施连续生命体征监测并没有减少医务人员访视次数或个人防护设备使用量。改良预警评分访视次数随时间下降,但这与引入连续监测无关。进一步定量和定性分析连续监测对医院工作人员工作流程的影响将提高我们对这种新型干预措施的认识,并可能揭示增加其有效性的关键点。

原文出处:

H.M.R. van Goor, Y. Eddahchouri, et al Can continuous remote vital sign monitoring reduce the number of room visits to patients suspected of COVID-19: A quasi-experimental study, International Journal of Nursing Studies, 2021,https://doi.org/10.1016/j.ijnurstu.2020.103868

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    2021-12-29 菲菲733
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    2021-10-15 风湿免疫科医生

    哈哈哈哈

    0

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    2021-10-15 谭桂峰

    加强公共卫生预防

    0

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