Published Article

ABSTRACT

Patient monitoring on low acuity general hospital wards is currently based largely on

intermittent observations and measurements of simple variables, such as blood pressure and

temperature, by nursing staff. Often several hours can pass between such measurements and

patient deterioration can go unnoticed. Moreover, the integration and interpretation of the

information gleaned through these measurements remains highly dependent on clinical

judgement. More intensive monitoring, which is commonly used in perioperative and intensive

care settings, is more likely to lead to the early identification of patients who are developing

complications than is intermittent monitoring. Early identification can trigger appropriate

management, thereby reducing the need for higher acuity care, reducing hospital lengths of stay

and admission costs and even, at times, improving survival. However, this degree of monitoring

has thus far been considered largely inappropriate for general hospital ward set- tings due to

device costs and the need for staff expertise in data interpretation. In this review, we discuss

some developing options to improve patient monitoring and thus detection of deterioration in

low acuity general hospital wards.

KEYWORDS: Identification, respiratory deterioration, Pulse oximetry, Capnography,

Benefits, disadvantages, waveform Capnography, Multiparameter