Post on 03-Feb-2021
transcript
Cork University Hospital Living Lab
Dr Des MurphyConsultant Respiratory Physician CUH
National Clinical Lead for Respiratory Medicine
AUTUMN DIGITAL ACADEMY FORUM-INNOVATING WITH DIGITAL HEALTH LIVING LABS
Respiratory Rate
• Number of breaths per minute.
• Problem;
– too many
– too few
• A Vital sign.
NCP/ITS CRS
• How do you measure Respiratory Rate?
• Manually count!
RespiraSense – Continuous monitoring of respiratory rate
• RespiraSense is a wireless wearable continuous respiratory rate (RR) monitor
• It operates by measuring movements of the chest and abdomen to calculate RR
• This approach enables Motion Tolerant measurements than produce reliable results to trigger timely action e.g. ABG testing
• Its can talk remotely to a single display so that Respiratory Compromise patients can be assessed should they decompensate in between intermittent vital sign observations.
• RespiraSense use in COVID-19 in Beaumont Hospital.
• Over 41.6% of EWS scores changed when RespiraSense measurements were used.
• Manual respiratory rate can impact the accuracy of Early warning Scoring
• Patients compensating with increased RR can mask signs of respiratory failure e.g. Hypoxia SpO2>92% events
• Respiratory Rate, with PaCO2 are strong markers of respiratory compromise, earlier than SpO2 measured desaturation.
• When respiratory rate was continuously monitored, future events of Hypoxia (>92% SpO2) and Pyrexia (>38 degrees) occurred12 hrs after patients RR elevated past 24 breaths per minute. Manual RR showed no prognostic power.
• What about other Respiratory Disease?
• Also while manual RR may cause problems with EWS, conversely all EWS scores were validated with manual RR.
• 20 Beds
• 4 High Dependancy
• 8 Centrally monitored
• 8 side rooms
To date…..
• 49 patients
• 51% male
• 53%>65 years
• Average duration wearing Respirasense=129 hours
• Diagnosis;
COPD 17
Asthma 12
Pneumonia 14
PH 3
Pulmonary Fibrosis 3
PE 2
• Ethics submitted
Acknowledgements
• 5B
• Deirdre Byrne
• Dr Anne Marie Sweeney
• PMD/Respirasense
Implementation of RespiraSenseHealthcare Professions are a multi-disciplinary team working with IT leads and
Executives to deliver safe and effective care.
Transforming healthcare requires a collective and collaborative approach to
ensure success and realize maximum impact.
Key preparation
activities pre-
launch of
RespiraSense
included:
WhyWe all need a purpose or a ‘Why’ so the team can align and push through
challenging hurdles.
WhoHealthcare professionals,
committees, IT teams, Executives, and patients are part developing the ‘Why’ we embark to Transform Care
WhatShared goals and a clear definition
of success ensure there is a destination
Secure system with minimum IT overhead
IT Teams
- Open Port
- Establish VNP
Estates
- Install Power and PoE Outlets
With clear objectives and goals, implementation is swift
1-day: Site survey to place routers
1-day: Front Line staff training, and clinical protocol setting
1-day: go live and ensure follow-on support is available