Authors (including presenting author) :
Lui CT (1), Tong WH (2), Hui Coe (2), Kong Karol (2), Chan HL (2), To CH (2), Lam MS (3), Chan Peter (4), Lo Edwin (4), Tang Karson (5), Kwok Andy (6), Hau LM (6)
Affiliation :
(1) Department of Accident and Emergency, NTWC
(2) Department of Medicine and Geriatrics, Tin Shui Wai Hospital
(3) Nursing Services Department, NTWC
(4) Information Technology Department, NTWC
(5) Administrative Services Department, NTWC
(6) Quality and Safety Division, NTWC
Introduction :
Unexpected patient deterioration, infusion pump and ventilator incidents are persistent threats during observation of ward patients, particularly when patient is located in segregated area such as isolation rooms where the audio alerts may be obscured. There is expectation from both staffs and public to implement IoT technologies to enhance patient observation.
Objectives :
To co-develop with a technology startup on a vendor-neutral middleware data integration solution and a closed-loop total system to notify ward nurses on equipment alert in closed-loop manner with working mobile.
Methodology :
Existing equipment in wards were connected up to central server, through various technologies including edge devices, direct WiFi integration, backend gateway-to-gateway configuration. Integrated equipment includes infusion and syringe pumps, physio and defibrillation monitors, telemetries, non-invasive and invasive ventilators, fall mats and patient call-bells, of different brands and models. Alerts and notifications will be directed to ward nurses through designated dashboard and native-apps on working mobile with closed-loop communication enabled. The CIMISEPS alerts covers wider scope than the equipment-level alerts, which can cover warnings on unexpected ventilator shutdown, prolonged ventilator standby idling, infusion or syringe pump out-of-dose range warning and prolonged pump idling.
Result & Outcome :
The CIMISEPS setup had been piloted in a ward in TSWH since September 2024. In first 3-months pilot, there are 71, 97 and 15 associations to infusion pump, patient monitors and ventilators of patients respectively. The median duration of CIMISEPS monitoring in infusion/syringe pump, patient monitors and ventilators are 486 minutes, 569 minutes (maximum 15.6 days) and 408 minutes (maximum 10.3 days) respectively.
During the 3-months pilot, 237 infusion or syringe pump alerts are flagged up (majorities are end-of-infusion alerts and pint-changing). 40 and 210 alerts from ventilators and patient monitors or telemetries were notified.
IoT technologies to connect up medical equipment in wards would enable more reliable and safer patient observation in ward. In the future, integration with corporate smart ward products such as IPMOE or eVital would enable process automation and efficiency. The CIMISEPS will be planned to out to all wards in TSWH.
