Physician Associate student presents research

Bangor Physician Associate student presents research at the prestigious “the Intensive Care Society State of the Art 2016” conference In London on 5th December 2016.

The conference gives an opportunity for practitioners to discuss and present research on the best of adult critical care, and also new ideas from acute medicine, cardiothoracics and PICU, and for the first time the UK's first professor of critical care nursing.

Former masters student Kate Darlington had her abstract  Continuous recording of respiratory rate to detect deterioration on general wards: Pilot study to evaluate feasibility for use with National Early Warning Score abstract selected as a NEW GENERATION E-POSTER presentation at the ExCeL, London

Kate giving an overview of the presentation she gave at the conferenceKate giving an overview of the presentation she gave at the conference.

Wrth siarad am ei phrofiad yn y gynhadledd, meddai Kate:

Talking about her experience at the conference Kate says:

“the experience was scary because I was the only PGT student presenting a work there, however also it was an amazing and good opportunity to practice my presentation skills.”

Bangor University is renowned for the high quality of student support available to students and Kate  is adamant that she couldn't have achieved this recognition for her research prowess without the support she received.

“I would like to say thank you for all support I received from Dr Chris Subbe and Dr Jenny Byast, my dissertation supervisors”.

 The School is delighted for Kate on her achievement and the summary of her research findings are detailed below:

Monitoring patients’ vital signs outside an ICU relies on nursing staff conducting checks at set intervals. However, if the patient deteriorates between monitoring times, there may be a delay in detecting the change in their condition. Continuous monitoring of vital signs, in particular heart rate (HR) and respiratory rate (RR), may provide a mechanism to alert doctors or nurses of an imminent serious clinical events and subsequently avoid serious adverse events. Feasibility of continuous monitoring within the UK context of the National Early Warning Score (NEWS) (1) has not been evaluated.

VITAL II PLUS (REC reference: 15/WA/0377) is a prospective observational study conducted on two general wards in a district general hospital in North Wales. We compared recordings of respiratory rate by manual count with continuous recording from a wireless sensor during a 5-day period. Allocation of devices was at the discretion of clinical teams.

23 patients were included in the preliminary analysis, 12 from a respiratory and 11 from a gastro-enterological ward with general medical patients. 10 patients had chronic hypoxia due to severe COPD or pulmonary fibrosis, 9 patients had sepsis and 3 patients died. The mean length of stay was 14 days.

In total there were 564 manual RR measurements and 43,894 sensor RR measurements. Frequency distribution of manually (Fig 1) and wirelessly (Fig 2) collected respiratory rates were compared. The proportion of high RR values that would have led to allocation of 3 points on the National Early Warning Score was significantly higher in measurements from the sensor than in manual measurements (41% vs 7%, p<0.0001). Mean variation of RR during a 6 hour period was 21 (SD 6).

VITAL II PLUS has found marked differences between the manual and wireless sensor RR measurements: sensor derived measurements were higher and more varied. Clinical implementation would translate in more alerts being Fig 1: Manual measurements of Respiratory Rate Fig 1: Manual measurements of Respiratory Rate generated.

Lower manual recordings might in part be due to measurements in resting patients. In order to assure comparability a method of distinguishing between deterioration and ‘exercise’ needs to be implemented to overcome potential alarm fatigue relating to clinically insignificant alerts. Existing algorithms might need significant adaption if using continuous recordings.

 

 

Fig 2: Wireless sensor measurements of Respiratory RateFig 2: Wireless sensor measurements of Respiratory Rat

References

[1.]       Jones M. NEWSDIG: The national early warning score development and implementation group. Clinical Medicine, Journal of the Royal College of Physicians of London. 2012. 12(6). 501–3.

Publication date: 13 December 2016