London nurses co-develop mobile app to tackle patient deterioration 

Nurses and physicians in London alongside IT services company ThinkShield have developed an app to help identify deteriorating patients earlier.

The ThinkVitals app – co-created by ThinkShield and the Chelsea and Westminster Hospitals NHS Foundations trust – has gone live across all adult wards at Chelsea and Westminster Hospital. The app could potentially save up to 60 lives per year.

The ThinkVitals app works by having vital signs information inputted into it via handheld devices, replacing the use of paper-based observation charts. The app uses algorithms based off Early Warning Scores and NICE guidelines to calculate and identify patients most at risk and who need urgent treatment.

Wards are also displayed on large screens throughout the hospital and are colour-coded to give nurses and doctors an idea of 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 know constantly 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 group leading the ThinkVitals app invited and acted on regular feedback from clinical staff to increase usability and minimise disruption to current workflows.

Dr Quinn added: “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. 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. 84% of respondents welcomed the digitisation of all nursing documentation in the future to help reduce paper usage, improve confidentiality and security, reduce risk of losing observations charts, and improving communication across the ward teams.

Dr Gary Davies, clinical director for Acute Services at the trust commented: “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 that 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”.

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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