Critical Appraisal of the research article “Experiences of current vital signs monitoring practices and views of wearable monitoring: A qualitative study in patients and nurses”

Introduction 

Monitoring of vital signs of patients is a critical responsibility of nurses in clinical and hospital settings. Timely monitoring assures nurses of diagnosing correct underlying causes behind medical conditions (Webster et al., 2022). It allows them to detect patient deterioration and take timely interventions for treatment and cure. The central theme of this study revolves around qualitative research to understand the experiences of nurses and patients regarding vital sign monitoring and ambulatory monitoring devices. It is chosen for analysis as it provides significant information for manual and continuous monitoring methods and sheds light on its advantages and limitations regarding patient care (Dunn et al., 2018). 

Aim and Hypothesis 

The primary aim of the selected article is to collect feedback and experiences of nurses and patients with existing practices in monitoring vital signs and assess their views on ambulatory monitoring technology (Areia et al., 2021). The author hypothesizes that while continuous monitoring of vital signs is crucial, the process can be advantageous with continuous monitoring technologies like ambulatory or wearable technologies. They offer benefits in the aspect of early detection, however also raise concerns in terms of noise, patient comfort, nurse-patient interaction and data accuracy and trustworthiness.

The study explores whether wearable technologies are truly effective and can replace manual observation methods and impact the quality of patient care and safety. The hypothesis suggests that ambulatory monitoring/ wearable technology could enhance the efficiency of monitoring vital signs, but only when they are trusted by patients and nurses and do not compromise patient centricity and quality of patient care. 

Description 

The current chosen case study is based on a qualitative research design, using semi-structured interviews as a tool for data collection and contributes to evidence-based practice. It takes into account insights from both the patient as well as nurses which is the positive part of the study. The method take into consideration the views of both groups. However, it might be varied for different hospital settings and cannot be applied to local healthcare settings without careful consideration of other aspects as well. 

The clinical site chosen for the study regularly used both manual as well as automated monitoring methods. This criterion helped to collect mixed feedback for different sorts of experiences. In manual method, mainly involved routine checks and monitoring by nurses while continuous monitoring utilized devices which automatically recorded vital signs such as heart rate, respiratory rate and oxygen saturation level (Areia et al., 2021).

Key aspects that emerged from the interviews included the importance of accuracy in monitoring vital signs, the trustworthiness of collected data, the need for balance between technology and human interaction, and concerns about the potential for wearable technology to reduce the quality of patient care. Both the group, nurses and patients expressed positive feedbacks but also raised certain concerns. (Wearables Will Transform Health but Changes Bring Challenges Say Researchers, 2023).

Analysis of Results and Findings 

The interview findings of patients and nurses reveal nuanced views of vital sign monitoring practices and integration with wearable technology. Nurses expressed a strong preference for manual monitoring, especially for critical patients taking into view the personalized care aspect along with accurate assessments of results. However, they also acknowledged continuous monitoring which through wearable as it was beneficial in gaining necessary information about patient’s conditions during their inability to perform checks manually.

Patients supported continuous monitoring aspect as they stayed secure. However, they were concerned about the discomfort and invasiveness of wearable devices. The reliability of automated results was often questioned by nurses and patients with proposing additional double check for ensuring trustworthiness of results.

A summation of key findings suggests that there is a need for a hybrid approach which incorporates manual and technological aspects. Other research findings also indicate that technology should complement healthcare professionals because the reliability of technological findings is often questionable due to the potentiality of error and faulty parameters (Amin et al., 2021). It also emphasize the importance of designing wearable technologies which is comfortable and reliable (Huhn et al., 2022) (User, 2022). 

The analysis of the mere study should not become a decision-making factor as this study has certain limitations. These limitations are due to the small sample size of patients and nurses with a narrow focus on selected objectives. Secondly, the study is also limited to the single surgical ward which was the part of future VHDL project. The results are transparent but less transferable to other hospital settings. This is because findings might vary with hospital size, hospital speciality, number of beds, and staff availability (Areia et al., 2021).  

Strategies

The positive factors of the nursing case study are that it provides several strategies for improving practices for vital signs monitoring in routine practice which is the integration of wearable technology. Training healthcare professionals on effective utilization of such technology might be useful for ensuring continuous monitoring of patients. The training should be designed to make them versed in troubleshooting aspects as well as effective usage to feel confident of the results (Edward et al., 2020).

To strengthen the use of technology by nurses in clinical practice, clear Standard Operating Procedures shall be developed by hospital. The SOPs shall be prepared using proper visuals and graphics to avoid any chances of error in its operation.  Mandatory training programs for ensuring competency for using such technology can be helpful. Nursing competency programs, webinars and seminars for technology use in clinical practice shall be enhanced (Smuck et al., 2021). 

Improvement in design and functionality is the area for the future scope of the current study. The collaboration of engineers and healthcare providers is positive in the long run improving the hospital system and complementing it with technological aspects (Wearable Activity Trackers Accelerate Hospital Patient Recovery, 2023.).

 

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Conclusion 

The current research study provided valuable insights into the experiences of patients and nurses regarding vital signs monitoring and wearable technology. The study presented perceptions from the small surgical ward, through provided the importance of balance between technology and human interaction. It suggested a hybrid approach as the most effective option for improving patient safety and care. Further research will be useful to complement this study and gain a better picture for addressing the raised concerns and ensuring the successful integration of wearable technology in clinical practice. 
References
Areia, C., King, E., Ede, J., Young, L., Tarassenko, L., Watkinson, P., & Vollam, S. (2021). Experiences of current vital signs monitoring practices and views of wearable monitoring: A qualitative study in patients and nurses. Journal of Advanced Nursing, 78(3), 810–822. https://doi.org/10.1111/jan.15055
Amin, T., Mobbs, R. J., Mostafa, N., Sy, L. W., & Choy, W. J. (2021). Wearable devices for patient monitoring in the early postoperative period: a literature review. mHealth, 7, 50. https://doi.org/10.21037/mhealth-20-131
Dunn, J., Runge, R., & Snyder, M. (2018). Wearables and the medical revolution. Personalized Medicine, 15(5), 429–448. https://doi.org/10.2217/pme-2018-0044
Edward, K. L., Garvey, L., & Rahman, M. A. (2020). Wearable activity trackers and health awareness: Nursing implications. International Journal of Nursing Sciences, 7(2), 179–183. https://doi.org/10.1016/j.ijnss.2020.03.006
Huhn, S., Axt, M., Gunga, H. C., Maggioni, M. A., Munga, S., Obor, D., Sié, A., Boudo, V., Bunker, A., Sauerborn, R., Bärnighausen, T., & Barteit, S. (2022). The Impact of Wearable Technologies in Health Research: Scoping Review. JMIR Mhealth and Uhealth, 10(1), e34384. https://doi.org/10.2196/34384
Smuck, M., Odonkor, C. A., Wilt, J. K., Schmidt, N., & Swiernik, M. A. (2021). The emerging clinical role of wearables: factors for successful implementation in healthcare. Npj Digital Medicine, 4(1). https://doi.org/10.1038/s41746-021-00418-3
User, G. (2022, January 31). Using wearables to create a proactive healthcare system — NSSN. NSSN. https://www.nssn.org.au/news/2022/1/24/transforming-healthcare-with-wearable-technologies
Webster, C. S., Scheeren, T. W., & Wan, Y. I. (2022). Patient monitoring, wearable devices, and the healthcare information ecosystem. British Journal of Anaesthesia, 128(5), 756–758. https://doi.org/10.1016/j.bja.2022.02.034
Wearables will transform health but changes bring challenges say researchers. (2023, August 9). The University of Sydney. https://www.sydney.edu.au/news-opinion/news/2023/08/09/wearables-will-transform-health-but-changes-brings-challenges-sa.html
Wearable activity trackers accelerate hospital patient recovery. (2023.). Home. https://unisa.edu.au/media-centre/Releases/2023/wearable-activity-trackers-accelerate-hospital-patient-recovery/