Overcoming barriers to continuous patient monitoring

Betty Ann Davis

Betty Ann Davis, R.N., M.S.N, C.N.E.

With healthcare costs increasing and budgets shrinking, hospital administrators are faced with the challenge of providing the best possible care while keeping their facility in the black. As a result, in an effort to stem the tide and maintain a high standard, new technologies are being brought into hospitals. However, despite the clinical and financial incentives these technologies offer, they are not always adopted with ease.

One such technology is continuous patient monitoring in non-Intensive Care Unit (ICU) settings, where the nurse-to-patient ratio makes constant monitoring by staff challenging. Continuous monitoring reduces workload on staff by providing constant real-time data with minimal false alerts as well as early detection of potential adverse events.   

Below, we’ll examine some of the potential barriers medical facilities see in continuous monitoring solutions, and how modern devices are overcoming these hurdles.

Alarm fatigue

In some hospitals, patient to caregiver ratios can be as high as 6 to 1. This means that when using traditional monitors in non-acute settings – intended for ICUs or operating rooms where the ratio is far lower – nurses are often responding to alarm after alarm, of which 85-99 percent typically do not require clinical intervention. This phenomenon, known as ‘alarm fatigue,’ puts patients at risk as staff become apathetic to the alarms, and adversely affects the work environment for healthcare providers.

New continuous monitoring solutions created specifically for non-acute settings provide digital records of patients that can be viewed on a monitor by the bed or remotely on smart devices – enabling an accurate picture of the situation. In addition, with customizable parameters – nurses can adjust the alarm threshold to match a patient’s condition and limit the number of alarms without turning off alarms or monitoring systems.

Technophobia

With hospitals becoming more complex and technology heavy, healthcare professionals can, understandably, be wary of yet another ‘gadget’ that may make their jobs initially more difficult. Steep learning curves, redundant data and more wires are just some of the concerns they have.

Fortunately, new monitoring solutions are often wireless, very simple to use and integrate well into the daily digital life people already lead through their smartphones and apps. In addition, these technologies offer multi-parameter solutions that reduce the need for older, single-use systems that crowd workstations and patient rooms.

Cost

Every new technology that is considered in hospitals faces the challenge of fitting into ever-conservative budgets. Indeed, while making life a bit easier for healthcare staff is laudable, if it comes at a significant price, many hospitals won’t consider it.

However, with current industry regulations that penalize hospitals with high readmission rates or extended patients stays, continuous monitoring can actually save hospitals money over time. Recent studies have shown that, on average, one hospital day is saved for every three patients who were continuously monitored. Additionally, a study by a leading teaching institute in Cleveland Ohio recently indicated that continuous respiratory monitoring can be an effective predictor of hospital readmission for heart failure patients. Frequent readmissions are a significant contributor to the high cost of associated with heart failure, estimated at $39 billion annually.

Looking forward

Healthcare is often stuck between a rock and a hard place – pressured to give better care while cutting costs.  Technology is the best answer to many aspects of this dilemma, including continuous monitoring. It creates a more conducive environment for professionals, with fewer alarms and distractions while maintaining and even increasing the quality of care patients receive and limiting wasted readmission costs.

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