548 EVALUATION OF A NOVEL AUTOMATED CONTINUOUS PATIENTMONITORING SYSTEM FOR VULNERABLE PATIENTS IN THE WARDS (POSTER PRESENTATION)

Introduction: Deterioration of patients in hospitals is typically preceded by changes in vital signs.Early warning scores (EWS) are currently used to assess risk, but depend on manual input of data by skilled nurses.A continuous vitals monitoring solution was proposed which can enable the automated recording of 6 key vitals -Heart rate, Blood Oxygen Saturation, Respiratory Rate, 3-lead Electrocardiogram, Non-invasive Blood Pressure and skin temperature.This also provided trends of data captured every 5 minutes and used Modified Early Warning Scores (MEWS) to aid clinical decisions.Clinical efficacy of this system was assessed for vulnerable patients in a non-ICU setting.Methods: An observational study was conducted in a tertiary care hospital (December '18 -February '19) which included vulnerable patients admitted to digestive diseases service.Vulnerable patients were defined as: 1) Gastrointestinal bleed patients with normal vitals at admission and 2) Post-operative/post intervention patients including transplant recipients who require monitoring as assessed by the intensivist.Patients were monitored for a minimum of 8 hours in a designated continuous-monitoring ward.The continuous monitoring system (the STASIS Monitoring Solution) provided live wave forms and recorded trends of patient vitals.This was wirelessly transmitted to a central tablet kept with the nurse and was made available on the doctor's mobile app via a cloud service.There were no changes applied to the existing nurse to patient ratio for the study.Decision to shift to the ICU was based on MEWS which was automatically generated from the continuous monitoring solution.The preceding time cohort (September 2018 -November 2018) was used as controls to compare the number of 'Code Blue' calls, average length of stay (ALOS), and ICU readmission rates.Results: Thirty eight vulnerable patients were included in the study (Mean age -61±14 years, M: F=6.6:1) and monitored for a total of 2248 hours.Five patients (13%) were found to have abnormal MEWS prompting a shift to the ICU.The number of admissions (10076 vs 9460 patients) and mean Charlson's comorbidity index (2.43 vs 2.17) of patients during the study period were higher as compared to controls.Despite this, there was a 67% reduction in the number of Code blue calls during the study period (3 calls vs 9 calls).[See Table 1] The ALOS and ICU readmission rate during the study period was 44.8% and 44.4% lower as compared to controls.Conclusions: Automated continuous monitoring of vulnerable patients in the non-ICU settings using this system is feasible and clinically beneficial for escalation of care.This can result in efficient utilization of hospital resources and reduce cost of treatment.Larger, controlled trials are required to quantify the clinical and fiscal benefits of universal implementation of such technologies.