University of Twente Student Theses


Continuous vital sign monitoring in COVID-19 patients

Biel, E.M. (2021) Continuous vital sign monitoring in COVID-19 patients.

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Abstract:The ongoing pandemic of the coronavirus disease 2019 (COVID-19) has put a huge pressure on all aspects of modern-day society. Healthcare systems are being faced with enormous challenges when it comes to managing capacity and dealing with high admission rates of critically ill patients. Hospitals have quickly adapted, for example by accelerating implementation processes of healthcare innovations. At the University Medical Centre of Utrecht a system for continuous vital sign monitoring was implemented at the COVID-19 cohort ward to support healthcare profesisonals and improve insight into continuous vital sign data of COVID-19 patients. This research focuses on evaluating the implementation process at the COVID-19 ward and analysing the acquired data to assess the possibilities of quantitatively detecting patient deterioration. The first component of this research concerns the evaluation of the implementation process of the continuous monitoring system, which was done by distributing two different questionnaires (among nurses and members of the monitoring team who were responsible for monitoring the data and operating the system). The second component concerns a case series report in which the continuous heart rate (HR) and respiratory rate (RR) data of eight selected patients was visually and quantitatively analysed along with patient specific context information. The third component concerns the exploration of quantitatively detecting patient deterioration by means of trend detection. This was done by developing a set of moving linear regression algorithms that were evaluated by applying them to the continuous HR and RR data of patients that experienced a severe case of deterioration. The nurses and the monitoring team showed a positive attitude towards the monitoring system. Short-term implementation processes can be optimised by focussing on adequate integration of the monitoring system into the workflow of nurses. Long-term implementation processes can be optimised by developing and upgrading both hardware and software components of monitoring systems. Continuous monitoring at the COVID-19 ward can be used to visually detect clinical deterioration as well as recovery by respectively observing a steadily increasing trend and a sinusoidal pattern that matches the circadian rhythm. Quantitative methods that were proposed to explore the feasibility of detecting patient deterioration by means of trend detection showed moderate results. Continuous vital sign monitoring is a valuable tool at the COVID-19 cohort ward, and implementation of continuous monitoring systems at other wards is recommended. Future work is needed to optimise continuous monitoring systems in terms of improving implementation processes and upgrading both hardware and software components (e.g. improving notification systems).
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine MSc (60033)
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