London nurses develop mobile app to tackle deterioration

Nurses at major London hospital help to extend functionality and go-live with vital signs technology by ThinkShield

Nurses at Chelsea and Westminster Hospital NHS Foundation Trust have collaborated with ThinkShield to develop and roll out a mobile vital signs app that could save up to 60 lives a year.

The app, called ThinkVitals, was initially launched across the hospital’s acute assessment unit and has now gone live across all adult wards at Chelsea and Westminster Hospital after extensive engagement with the nursing community.

Around 400 nurses and healthcare assistants are now inputting vital signs information, such as heart rate, blood pressure, temperature and respiratory rate into the ThinkVitals app via hand-held devices, replacing the use of paper-based observation charts.

The app generates approximately 61,000 transactions per day, almost two million per month.

By moving to an IT patient-based solution, the trust is benefitting from more-accurate and up-to-date reporting.

Any IT system that is user friendly is going to be much more attractive to nurses, and ThinkVitals is just that

The app’s algorithms use Early Warning Scores and NICE guidelines to automatically calculate and identify patients most at risk and who require prompt or urgent treatment.

Information captured on mobile devices is also presented as a colour-coded ward view on large screens, displaying each patient’s location and condition allowing nurses and doctors to tell, at a glance, which patients need to be prioritised for clinical review.

Among the additional functionality suggested and developed by nurses was a fluid balance module which supports nurses and physicians to monitor patients’ input and output.

Dr Barry Quinn, assistant director of nursing at the trust, said: “From a patient safety point of view, we need to constantly know a patient’s vital signs and that their fluid balance is correct in order to direct care and treatment.

“Using ThinkVitals we now know that every hour of every day the vital signs and fluid balance is up to date.”

The trust’s ThinkVitals steering group actively invited and acted on regular feedback from clinical staff, embracing the principles of user-centered design outlined in the Wachter Review to increase usability and minimise disruption to current workflows.

Dr Quinn said: “Nurses are experts in caring for people and need support with the growing need for IT in the clinical setting.

“Nursing care is a combination of clinical and human skills, supported by IT solutions.

From a patient safety point of view, we need to constantly know a patient’s vital signs and that their fluid balance is correct in order to direct care and treatment.

“Any IT system that is user friendly is going to be much more attractive to nurses, and ThinkVitals is just that.”

An internal survey by the trust revealed that 95% of nursing staff using the newly-developed system who responded found ThinkVitals easy to use and wanted to move even further towards IT clinical solutions for patients, highlighting the app’s popularity.

Dr Gary Davies, clinical director for acute services at the trust, said: “It’s almost unheard of in healthcare to get this kind of positive response on a user acceptance survey.

“It has been probably the easiest clinical IT project I’ve ever been involved in. What’s helped is that the whole project design has had significant clinical input at all levels as well as the interface looking like the familiar previous paper observations forms.

“This has made it easy for nursing teams to adapt during the digitisation process.”

Eighty-four per cent of respondents welcomed the digitisition of all nursing documentation in the future to help reduce paper usage, improve confidentiality and security, reduce the risk of losing observations charts, and improve communication across the ward teams.

The demand at both national and local level to better support deteriorating patients in busy hospitals is clear to see

Tim Taylor, managing director of ThinkShield, said: “The demand at both national and local level to better support deteriorating patients in busy hospitals is clear to see.

“Our aim was to bring a very-visual experience to nursing care, working closely with the frontline staff to make the application as highly intuitive and user-friendly as possible.

“This has helped minimise training, especially during change over, and overall help to deliver a product for nurses’ everyday clinical needs.”

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