According to a new study, the deaths of thousands of patients in hospital annually can be attributed to poor monitoring, mathematical errors and bad handwriting of nursing staff.
After nurses were provided with electronic devices, such as iPads, rather than handwritten notes to record patients’ breathing and heart rates, the death rate at two hospitals declined by 15%.
Researchers have calculated that around 750 deaths were prevented at the two hospitals, University Hospital in Coventry and Queen Alexandria in Portsmouth, on an annual basis. This means that 37000 deaths could be avoided if nurses were provided with the devices instead of depending on traditional handwritten notes.
Currently, nurses have the responsibility of measuring patients’ blood pressure, oxygen levels, heart rate and other reading, and note the results down on a board which is placed at the end of the bed. These readings are often not taken regularly and in certain patients, there have been gaps of between eight and 12 hours between the readings.
To try and overcome this problem, nurses at University Hospitals in Coventry and Queen Alexandra Hospital in Portsmouth were provided with hand-held devices during 2007 and 2005 respectively. They were given either iPads or iPhones, with suitable apps installed, to take patients’ readings and send reminders to the nurses as to the next reading time.
If the patient’s condition deteriorates, an alert flashes on the screen of the device and may in some cases urge the nurse to call a doctor.
The death rates were compared by researchers from 2004, prior to the use of the devices, to 2010.
At Portsmouth, the annual death rate declines by 397, and at University Hospitals Coventry, it declined by 372 during 2010, compared to 2004.
One of the project leaders, Dr Paul Schmidt, based at Portsmouth Hospitals NHS Trust, said patient observation and accurate records act as a safety net to deterioration. He said the team believed that paper charts were inadequate, so an electronic support system was designed, which resulted in a huge decline in the number of deaths.
Dr Duncan Watson from University Hospital Coventry, who was also part of the project team, said the technology allows the performance of routine, but important tasks to be improved, and it frees clinical staff to care for patients.
Many of the deaths that were avoided would have been the elderly who may have developed infections or pneumonia, which would normally have been detected too late.
The devices would generally come at a cost of around £500000 for a medium-sized hospital. Currently, there are around 40 hospitals using these devices in at least one department.