Early Warning System for Clinical Deterioration on General Hospital Wards

The Washington University

Status: Completed

Conditions: Escalation of Care; Respiratory Arrest; Cardiopulmonary Arrest; Severe Sepsis; Septic Shock

Treatments: Behavioral: EWS Nursing Alerts; Device: Wireless Remote Sensor

Study type: Interventional

Funder types: Other

Identifiers

NCT01280942

7322-01 (Other Grant/Funding Number)

10-0514

Details and patient eligibility

About

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.

Enrollment: 20,031 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• All patients age 18 and above, hospitalized in GHWs at Barnes Jewish Hospital.

Exclusion criteria

• Minors, patients younger than 18 years old.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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20,031 participants in 2 patient groups

Control

No Intervention group

Description:

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

Experimental group

Description:

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.

Treatment:

Device: Wireless Remote Sensor

Behavioral: EWS Nursing Alerts