Selected Case Studies - BEAI
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Selected Case Studies Using the EarlySense System DETECT EARLY • COMMUNICATE IMMEDIATELY • MANAGE EFFECTIVELY ENHANCE QUALITY OF CARE • TIMELY INTERVENTION • FALL PREVENTION
Transcript of Selected Case Studies - BEAI
Selected Case StudiesUsing the EarlySense System
Selected Case StudiesUsing the EarlySense System
D E T EC T EA R LY • CO M M U N I C AT E I M M E D I AT E LY • M A N AG E E F F EC T I V E LY
E N H A N C E Q UA L I T Y O F C A R E • T I M E LY I N T E RV E N T I O N • FA L L P R E V E N T I O N
IntroductionIn the past years the EarlySense System has been used in hospitals and long term care facilities worldwide. Caregivers have reported case studies in which the EarlySense System has helped them enhance the quality of care by early detection of patient deterioration or by fall prevention.
This booklet presents some of these cases.
Table of ContentsRespiratory Depression
Low Respiratory Rate Alerts Leading to Timely Detection of Respiratory Depression Following Narcotic Treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Low Respiratory Rate Alerts Leading to Identification of Respiratory Depression and to Timely Administration of Narcan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Respiratory ComplicationsHigh Respiratory Rate Alerts Leading to Detection of Pulmonary Embolism and to Timely Activation of RRT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
High Respiration Rate Alerts Leading to Rapid Identification of Aspiration and to Timely Intervention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
High Heart and Respiration Rate Alerts Leading to Timely Identification of Aspiration Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Cardiac ArrhythmiaHigh Heart Rate Alert Leading to Identification of Supraventricular Tachycardia (SVT) and to Timely Intervention and Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
High Heart Rate Alerts Leading to Timely Identification of Atrial Fibrillation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
High Heart Rate Alert Leading to Identification of A-Flutter and to Conversion to Normal Sinus Rhythm (NSR). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Other ComplicationsHigh Respiration Rate Alerts Leading to Timely Response to Acute Abdomen with Colonic Necrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
High Heart Rate Alerts Leading to Identification of Gastrointestinal Bleeding and to Timely Intervention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
High Respiratory Rate Alerts Leading to Timely Transfer to ICU and to Identification of Sepsis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Pain ManagementHigh Heart Rate Alerts Leading to Identification of Pain in a Non-Communicative Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Medication ManagementRespiration Rate Alerts and Heart Rate Trend Monitoring Leading to Change in Medical Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Fall PreventionBed Exit Alerts Preventing Falls in High Risk Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Bed Exit Alerts Leading to Timely Detection of a Medicated Patient Trying to Ambulate with No Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Bed Exit Alert Preventing Fall in Post-op Demented Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
EarlySense Selected Case Studies | 3
Legend of Acronyms: BPM = Beats Per Minute
Br/min = Breaths Per Minute
EKG = Electrocardiogram
GI = Gastrointestinal
HCT = Hematocrit
HGB = Hemoglobin
HR = Heart Rate
ICU = Intensive Care Unit
NSR = Normal Sinus Rhythm
RR = Respiration Rate
RRT = Rapid Response Team
WBC = White Blood Cells
Legend of Screen Lines & Icons:Lines
Respiratory Rate
Heart Rate
Movement Rates (0, Low, Medium, High, Extremely high)
Icons:
High/Low Heart Rate Alert
High/Low Respiration Rate Alert
Patient Turn Counter Alert
Technical Alert
Bed Exit Alert
Multiple Alerts
Patient Turned
The below system module icons appear beside each of the case studies relevant for the features they include:
“All in one” module “Vitals” module “Safety” module
* For further information see separate module brochures
A SV
EarlySense Selected Case Studies | 5Surg. Dep., Netherlands
Low Respiratory Rate Alerts Leading to Timely Detection of Respiratory Depression Following Narcotic Treatment
Narcotic Treatment 1Respiratory Depression
About the Patient:A 34 year old female hospitalized for a spinal fusion surgery due to spondylolisthesis. Following the surgery the patient was treated with Morphine.
EarlySense Indication:Shortly after the patient returned from surgery: Low RR alerts (6-7 Br/min)
Assessment:Respiratory depression due to narcotics was identified.
Response: A physician was called.
Morphine treatment was discontinued.
The patient was closely monitored.
Outcome: RR returned to normal and the patient stabilized. A few days later the patient was discharged to her home in good condition.
Icons:
Low Respiration Rate Alert
Technical Alert
Multiple Alerts
Lines
Respiratory Rate
Heart Rate
Movement Rates (0, Low, Medium, High, Extremely high)
6 | EarlySense Selected Case Studies Med-Surg Dep., California, USA
Low Respiratory Rate Alerts Leading to Identification of Respiratory Depression and to Timely Administration of Narcan
Narcotic Treatment 2Respiratory Depression
About the Patient:A female patient, hospitalized for orthopedic procedure (left leg fasciotomy and open reduction internal fixation).
EarlySense Indication: On the fourth day of the hospitalization, 30 minutes after the patient returned from her orthopedic procedure: Low RR alerts (8 Br/min)
Assessment: Narcotic-induced postoperative respiratory depression was identified.
Response: Narcan (narcotic antagonist) was administered.
Outcome: The patient’s RR increased and the patient stabilized.
Icons:
Low Respiration Rate Alert
Multiple Alerts
Lines
Respiratory Rate
Heart Rate
Surgery
EarlySense Selected Case Studies | 7Surg. Dep., Netherlands
High Respiratory Rate Alerts Leading to Detection of Pulmonary Embolism and Timely Activation of Rapid Response Team (RRT)
Pulmonary EmbolismRespiratory Complications
About the Patient:An 88 year old male hospitalized for orthopedic surgery.
EarlySense Indication:On the 4th day of the hospitalization at 6 AM: High RR alerts (32 Br/min) and increased HR
Assessment: Hypotension (84/57 mmHg) SpO2 was 96%.
Response: RRT was activated.
Pulmonary embolism was suspected and diagnosed.
Outcome: The patient was transferred to the ICU to continue monitoring and treatment. Icons:
Bed Exit Alert
Technical Alert
Lines
Respiratory Rate
Heart Rate
High Respiration Rate Alert
Multiple Alerts
8 | EarlySense Selected Case Studies
Icons:
High Respiration Rate Alert
Patient Turn Counter Alert
Multiple Alerts
Patient Turned
Med-Surg Dep., California, USA
About the Patient:A 74 year old male with a percutaneous endoscopic gastrostomy (PEG), admitted with a forehead laceration due to a slip and fall.
EarlySense Indication: On the first night of the hospitalization at 3 AM: High RR alerts (32 Br/min) and increased HR
Assessment: Aspiration of PEG feedings was identified.
Response: Suctioning and breathing treatment were performed.
Outcome: The patient stabilized and was discharged the following day to a skilled nursing facility.
High Respiration Rate Alerts Leading to Rapid Identification of Aspiration and Timely Intervention
AspirationRespiratory Complications
Lines
Respiratory Rate
Heart Rate
Movement Rates (0, Low, Medium, High, Extremely high)
EarlySense Selected Case Studies | 9Post-Acute Care Dep., Nursing Home, NY
About the Patient:An 81 year old female with dementia admitted following Sepsis and Cerebrovascular Accident (CVA) with Right hemiparesis.
EarlySense Indication:On the 30th day of the hospitalization at 12:10 AM: Alerts of high HR (130 BPM) and RR (38-41 Br/min) alerts
Assessment:The patient was found to be short of breath. Blood work results showed elevated WBC.
Response:Nebulizer treatment was administered. The patient was transferred to the hospital to rule out Sepsis / GI bleed / Aspiration Pneumonia.
Outcome:At the hospital the diagnosis was confirmed to be Aspiration Pneumonia and the patient was treated accordingly.
Aspiration Pneumonia
High Heart and Respiration Rate Alerts Leading to Timely Identification of Aspiration Pneumonia
Respiratory Complications
Lines
Respiratory Rate
Heart Rate
EarlySense Patient Status Report
10 | EarlySense Selected Case Studies Med-Surg Dep., CA, USA
Supraventricular Tachycardia
About the Patient:A 53 year old female, status post hemicolectomy.
EarlySense Indication:On the first night of the hospitalization at 12:53 AM: High HR alert (191 BPM)
Assessment:Tachycardia of 190-200 BPM was confirmed.
Response: MD was called. EKG showed SVT. Continuous EKG monitoring was applied. Adenosine was given, leading to HR reduction.
The patient was transferred to the ICU.
Outcome: The patient stabilized. Five days later the patient was discharged to her home.
High Heart Rate Alert Leading to Identification of Supraventricular Tachycardia (SVT) and to Timely Intervention and Transfer
Cardiac Arrhythmia
Icons:
High Heart Rate Alert
Multiple Alerts
Lines
Respiratory Rate
Heart Rate
EarlySense Selected Case Studies | 11Med-Surg Dep., MA, USA
Atrial Fibrillation
About the Patient:A 73 year old female with small bowel obstruction secondary to incarcerated inguinal hernia.
EarlySense Indication:On the second day of the hospitalization, at 9:40 PM: High HR alert (140 BPM)
Assessment: BP was 92/64 mmHg. EKG was done. Rapid atrial fibrillation and cardiac distress were identified.
Response: Lopressor and Diltiazem were given – with no response. The patient was transferred to CICU for Diltiazem drip and for further cardiac examination.
Outcome: The patient converted to normal sinus rhythm and stabilized. Two days later the patient was transferred back to the med-surg floor.
High Heart Rate Alerts Leading to Timely Identification of Rapid Atrial Fibrillation
Cardiac Arrhythmia
Icons:
High Heart Rate Alert
Lines
Respiratory Rate
Heart Rate
12 | EarlySense Selected Case Studies Med-Surg Dep., MA, USA
About the Patient:A 55 year old female with metastatic lung cancer. History of pneumonia, embolus and stroke. Hospitalized for over a month, awaiting rehab placement.
EarlySense Indication:7:30 AM: High HR alerts (180’s BPM)
Assessment: Complaints of palpitations and light headedness.
The patient had not reported this thinking it was part of her diagnosis.
EKG was done.
Atrial flutter was identified.
Response: Metoprolol was given.
Outcome: The patient converted to normal sinus rhythm and transferred to telemetry unit for further observation.
High Heart Rate Alert Leading to Identification of Atrial Flutter and to Conversion to Normal Sinus Rhythm
Atrial FlutterCardiac Arrhythmia
Icons:
High Heart Rate Alert
Multiple Alerts
Lines
Respiratory Rate
Heart Rate
EarlySense Selected Case Studies | 13Post-Acute Care Dep., Nursing Home, NY, USA
Acute Abdomen with Colonic Necrosis
About the Patient:An 88 year old female admitted for swallowing dysfunction treatment.
EarlySense Indication:On the day of the planned discharge, Alerts of high RR (45-48 Br/min). In addition, the patient vomited 4-5 times after breakfast.
Assessment:The patient was pale, complained of nausea and vomiting. Abdominal tenderness was noted.
Response:MD was called. Stat EKG and blood work were ordered.
Elevated WBC and low HGB and HCT were found.
The patient was transferred to the hospital for further treatment.
Outcome: Colonic necrosis was diagnosed. Emergency surgery was performed and the patient stabilized.
High Respiration Rate Alerts Leading to Timely Response to Acute Abdomen with Colonic Necrosis
Other Complications
Icons:
High Respiration Rate Alert
Multiple Alerts
Lines
Respiratory Rate
Heart Rate
14 | EarlySense Selected Case Studies Med-Surg Dep., California, USA
About the Patient:A male hospitalized with respiratory failure, tachycardia, fever, diabetes and alcoholism
EarlySense Indication: On the third day of hospitalization, at 4 AM: High HR alerts (130-150 BPM); Consistent and gradual trend of HR increase (105 BPM - 155 BPM)
Assessment: Tachycardia and distress
Response: A physician was called.
GI bleeding was suspected.
The patient was transferred to ICU.
Outcome: Upper GI bleeding was diagnosed by gastroscopy. The patient was treated in the ICU and discharged two days later.
High Heart Rate Alerts Leading to Identification of Gastrointestinal Bleeding and to Timely Intervention
Gastrointestinal (GI) BleedingOther Complications
Icons:
High Heart Rate Alert
Bed Exit Alert
Multiple Alerts
Lines
Respiratory Rate
Heart Rate
EarlySense Selected Case Studies | 15Med-Surg Dep., California, USA
Sepsis
About the Patient:A 76 year old female admitted with acute pancreatitis.
EarlySense Indication:On the first day of the hospitalization, High RR alerts (40-60 Br/min) and increased HR.
Assessment:HR was 118-126 BPM, Oxygen saturation was 90%. The patient was having difficulty breathing and right chest pain. Arterial blood gases revealed metabolic acidosis (pH 7.27).
Response: The patient was treated with IV antibiotics, fluids and sodium bicarbonate drip. The patient was transferred to the telemetry floor and due to a drop in blood pressure was later transferred to ICU, where she was intubated.
Necrotizing Pancreatitis and Sepsis were diagnosed.
Outcome: Following treatment, the patient’s condition gradually improved.
High Respiratory Rate Alerts Leading to Timely Transfer to ICU and to Identification of Sepsis
Other Complications
Icons:
High Respiration Rate Alert
Multiple Alerts
Lines
Respiratory Rate
Heart Rate
16 | EarlySense Selected Case Studies Post-Acute Care Dep., Nursing Home, NY, USA
Detection of Pain
About the Patient:An 85 year old non-communicative female with dementia admitted with hairline fracture of the right shoulder.
EarlySense Indication:On the 6th day of the hospitalization, at 11:20 AM: High HR Alerts (140 BPM) and increased RR (30 Br/min)
Assessment: The patient was unable to verbalize her needs but appeared to be uncomfortable. A physician recognized inadequate pain control.
Response: The patient’s pain control medication was upgraded.
Outcome: The patient became more comfortable. HR and RR decreased.
High Heart Rate Alerts Leading to Identification of Pain in a Non-Communicative Patient
Pain Management
Icons:
High Heart Rate Alert
Patient Turn Counter Alert
Multiple Alerts
Lines
Respiratory Rate
Heart Rate
EarlySense Selected Case Studies | 17Med-Surg Dep., MA, USA
Icons:
High Respiration Rate Alert
Patient Turn Counter Alert
Technical Alert
Patient Turned
Detection of Missed Dose
About the Patient:A 77 year old female with history of Diabetes, CHF and Peripheral Vascular Disease, admitted due to CHF exacerbation, Pneumonia, and gangrene of foot, calf and leg.
EarlySense Indication: On the second day of the hospitalization, at 8 AM: High RR alert (32 Br/min) and increased HR.
Assessment: Trends showed elevated HR. Chart review revealed that medications had been on hold since previous shift.
Response: Metoprolol and Furosemide were given.
Outcome: The patient stabilized.
Respiration Rate Alerts and Heart Rate Trend Monitoring Leading to Change in Medical Management
Medication Management
Lines
Respiratory Rate
Heart Rate
18 | EarlySense Selected Case Studies Surg. Dep., Netherlands
Patient at High Risk of Fall
About the Patient:A 90 year old female hospitalized at the surgical department for dynamic hip screw operation. The patient had delirium and was considered to be in danger of falling.
EarlySense Indication:Bed Exit alerts
Assessment:The patient was trying to leave the bed.
Response:The nurses assisted the patient and prevented her from falling.
Outcome:The patient was safely hospitalized and treated.
Bed Exit Alerts Preventing Falls in High Risk Patient
Fall Prevention
“Without the system, we could not prevent the patient from falling”
– RN
HR alert limits: 40/120RR alert limits: 8/30Bed exit alert: Sensitivity 2 (1 - lowest, 6 - highest).Patient Turn Counter: OFFMovement Alert: ON
Patient Status Report Patient ID:507504Updated:May 23, 2011 11:49 PM Admitted:May 19,2011, 7:41 PMRoom-bed:305-2 Date-of-Birth:Initials:C H Gender:03.72
Alerts and Trends Report
Initial Settings - as of May 22, 2011 at 4:00 am.
Daily Alerts and Setting Changes
Date Time Type Setting ChangeMay-23-2011 1:39 AM Turn counter exceeded
5:24 AM Turn counter exceeded7:57 AM Turn counter exceeded3:18 PM Turn counter exceeded5:22 PM Turn counter exceeded9:36 PM Turn counter exceeded
Cumulative Trend Analysis - Overnight averages between: 00:00-04:00 am
Date HR[BPM]
RR[BR/min]
MOV [%] No. of Bed Exit
May-20-2011 53±2 14±1 0.3 0May-21-2011 51±3 14±1 0.6 0May-22-2011 54±4 15±1 0.6 0May-23-2011 49±2 14±1 0.6 0
20110519_194137_507504.pdf 3 / 4
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EarlySense Patient Status Report
EarlySense Selected Case Studies | 19Med-Surg Dep., FL, USA
Patient at High Risk of Fall
About the Patient:A 47 year old female with hepatitis C and cirrhosis hospitalized due to abdominal pain. The patient was treated with pain killers.
EarlySense Indication: 1:48 AM – Bed Exit alert, 6:42 AM – Bed Exit alert
Assessment: The patient was sitting on the side of the bed saying she was going to get up to go to the bathroom. The patient did not call for assistance
Response: The Patient Care Technician (PCT) helped the patient, who was unsteady on her feet, ambulate to the bathroom
Outcome: Twice that night the PCT came to the room in a timely manner to assist the patient, who was unable to ambulate without assistance. This possibly prevented a fall and an injury.
Bed Exit Alerts Leading to Timely Detectionof a Medicated Patient Trying to Ambulate with No Assistance
Fall Prevention
“The Bed Exit alert came to my pager and I was able to reach the patient in time to prevent
her from falling when the medication made her unstable on her feet.”
– C.C., PCT
20 | EarlySense Selected Case Studies Rehab Dep., Israel
Patient at High Risk of Fall
About the Patient:A 93 year old demented female admitted for rehab following hip surgery.
EarlySense Indication:Bed exit alert at 1:20 AM
Assessment:The patient was found attempting to leave her bed, raising her legs over the bed’s side rail.
Response:The nurse helped the patient to lie back in her bed.
Outcome:Fall event and further possible complications were prevented.
Bed Exit Alert Preventing Fall in Post-op Patient with Dementia
Fall Prevention
Need screen
EarlySense Selected Case Studies | 21
The EarlySense System:
A comprehensive patient monitoring solution providing continuous vital sign and motion information for the general care departments.
Bedside Unit Contact-free Sensor Central Display Station Transmitter & Pager Devices Hallway Screen
About EarlySenseEarlySense develops innovative patient monitoring and supervision technologies to advance proactive reduction of adverse events and improve patient outcomes.
For additional information, please visit www.earlysense.com
PROPRIETARY NOTE: The information contained within this document is the property of EarlySense. Any attempt to copy or distribute without written consent from EarlySense shall be considered unlawful.
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MK660_Rev 3
