Research Finds Dozee EWS Could Bring ICU-Level Early Detection of Patient Deterioration to General Wards

The study published in the journal Frontiers in Medical Technology has emphasised that Dozee-EWS operates by issuing timely alarms to aid in the early detection of patient deterioration. Additionally, this system can provide significant time savings, enabling healthcare practitioners (HCPs) to optimise care and dedicate more attention to direct patient interactions.

Continuous patient monitoring in general wards comes with significant challenges due to the absence of suitable systems that can match the level of vigilance seen in ICUs. The Dozee Early Warning System (Dozee-EWS) was developed to address the limitations of current monitoring systems in general wards.

Traditional methods, such as intermittent spot checks for heart rate, respiratory rate, and blood pressure every 3–6 hours, risk missing critical changes between checks and consume significant healthcare practitioners' (HCP) time. Existing Early Warning Systems like MEWS and NEWS, while useful, often yield false positives and cannot track vital sign trends effectively. Contact-based continuous monitoring technologies, such as sphygmomanometry and electrocardiography, can cause discomfort, sleep disturbances, and skin irritation.

The Dozee-EWS was made to overcome these issues by offering contactless, continuous monitoring with a alerting system to improve early detection of patient deterioration and optimise HCP efficiency.

To evaluate the Dozee-EWS's efficacy in improving the early detection of clinical deterioration, Ambuj Yadav, Department of Medicine, King George's Medical University, Lucknow, India and colleagues conducted a prospective observational cohort study in the medical unit of a tertiary care hospital in India, involving 706 patients over 84,448 monitoring hours.

For the study, researchers use a contactless ballistocardiography system (Dozee system) that continuously monitors heart rate, respiratory rate, and blood pressure. The study evaluated the total, mean, and median number of alerts at 24, 48, 72, 96, and 120 hours, as well as throughout the length of stay (LOS) until patient deterioration or discharge. It examined the sensitivity and specificity of the alerts, the average time from the first alert to patient deterioration, and the activities of healthcare practitioners (HCPs).

The study concluded the following:

• Among the 706 patients, 33 (5%) experienced clinical deterioration, whereas 673 (95%) did not.
• The group that experienced clinical deterioration consistently showed a higher number of alerts at all time points compared to those who were discharged without issues.
• On average, the time from the initial alert to clinical deterioration was 16 hours within the 24 hours leading up to the event.
• The sensitivity of the Dozee-EWS ranged from 67% to 94%. Healthcare practitioners (HCPs) dedicate 10% of their time to checking and documenting vital signs.

The researcher noted that the study is limited by its single-centre scope and observational design. Nevertheless, the findings emphasize the potential of advanced monitoring technologies to enhance clinical outcomes and operational efficiency in hospitals with limited resources.

Reference: Yadav, A., Dandu, H., Parchani, G., Chokalingam, K., Kadambi, P., Mishra, R., Jahan, A., Teboul, J.-L., & Latour, J. M. (2024). Early detection of deteriorating patients in general wards through continuous contactless vital signs monitoring. Frontiers in Medical Technology, 6. https://doi.org/10.3389/fmedt.2024.1436034