Early Warning System for Clinical Deterioration on General Hospital Wards.
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 20,031
- Locations
- 2
- Primary Endpoint
- Transfer to ICU or Unexpected Death Within 24 Hrs of Identification by the EWS Algorithm
Study Overview
Brief Summary
The goal is to develop a two-tiered monitoring system to improve the care of patients at risk for clinical deterioration on general hospital wards (GHWs) at Barnes-Jewish Hospital (BJH). The investigators hypothesize that the use of an automated early warning system (EWS) that identifies patients at risk of clinical deterioration, with notification of nurses on the GHWs when patients are identified, will reduce the risk of ICU transfer or death within 24 hrs of an alert. As a substudy, the investigators will pilot the use of a wireless pulse oximeter to establish feasibility and to develop algorithms for a real-time event detection system (RDS) in these high-risk patients.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Crossover
- Primary Purpose
- Prevention
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •All patients age 18 and above, hospitalized in GHWs at Barnes Jewish Hospital.
Exclusion Criteria
- •Minors, patients younger than 18 years old.
Arms & Interventions
Control
Patients admitted to 4 GHWs designated as controls. Nurses will not be notified when patients on these GHWs satisfy the EWS algorithm. They will also not wear the wireless sensor devices.
Nurse notification of EWS alert
Patients admitted to 4 GHWs designated as intervention wards at BJH. Nurses will be notified when patients on these wards satisfy the EWS algorithm. Some patients will be asked to wear the wireless remote sensors.
Intervention: EWS Nursing Alerts (Behavioral)
Nurse notification of EWS alert
Patients admitted to 4 GHWs designated as intervention wards at BJH. Nurses will be notified when patients on these wards satisfy the EWS algorithm. Some patients will be asked to wear the wireless remote sensors.
Intervention: Wireless Remote Sensor (Device)
Outcomes
Primary Outcomes
Transfer to ICU or Unexpected Death Within 24 Hrs of Identification by the EWS Algorithm
Time Frame: Within 24 hrs of an EWS alert
The proportion of patients transferred to ICU or death within 24 hrs of identification by the EWS algorithm for intervention and control wards.
Secondary Outcomes
- Clinical Outcomes and Process Measures(Hospital discharge)