Feasibility of Wireless Continuous Vital Sign Monitoring and Impact on Patients Undergoing Adult Spinal Surgery in a General Ward

Patients undergoing adult spinal deformity surgery (ASD) is associated with high complication rate and long postoperative recovery (Bess et al., 2023). Patients undergoing ASD surgery are particularly susceptible to adverse events such as electrolyte imbalance, cardiac arrhythmia, anemia, hypotension, fever of unknown origin (Karstensen et al., 2016; Solumsmoen et al., 2021). Additionally, patients undergoing ASD surgery is also associated with severe postoperative pain, often requiring high levels of pain medication (Lamperti et al., 2017; Waelkens et al., 2021), there can lead to decreased respiration rate, sedation, and dizziness (Benyamin et al., 2008).Patients undergoing ASD surgery have a readmission percent within 30 days of 11,8 % and a 2-year all-cause mortality of 3% (Bari et al., 2020).

To ensure safety in patients undergoing ASD surgery, nurses must monitor vital signs to assess patients' health condition and act promptly when signs of clinical deterioration become evident. NEWS2 system is used to identify these early signs of clinical deterioration (Smith et al., 2019). The scoring system relies on six simple physiological parameters, including blood pressure, pulse, respiratory rate, peripheral oxygen saturation, temperature, level of consciousness and an associated algorithm (Smith et al., 2019). Since measurements with NEWS2 are intermittent, they often provide a temporary view of the patient's condition, and the system may therefore overlook changes in the patient's condition that occur between measurement (Downey et al., 2017).

Wireless continuous vital sign monitoring (wCVSM) offers an alternative to intermittent measurements. wCVSM systems can be defined as wearable technologies that enable continuous, real-time vital sign monitoring without direct contact between patients and health-care providers. These systems transmit vital sign data to an application on the nurses´ mobile phones, enabling the recognition of clinical deterioration in real time and facilitating a prompt response to patients' needs (Haahr-Raunkjaer et al., 2022; Leenen et al., 2020). To evaluate the feasibility of wCVSM, it is essential to assess its acceptability among orthopaedic surgical nurses and patients undergoing ASD surgery. Their perceptions and willingness to adopt this technology are essential for ensuring its practical integration, consistent use, and long-term sustainability in enhancing clinical outcomes and patient safety.

This study will contribute to our understanding of wCVSM's potential to enhance patient safety, its applicability in clinical practice, and provide necessary considerations when implementing new technological equipment.

In the current study patients undergoing ASD Surgery will, in addition to standard care the National Early Warning Score 2 (NEWS2) be monitored by wireless continuous vital sign monitoring (wCVSM) using the multiparameter ambulatory telemonitoring system CPC12S system and WARD-CSS application postoperatively.