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Health Care Professionals’ Views of Smart Glasses for Vital Signs Monitoring in Complex Care Environments
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.ORCID iD: 0000-0003-3348-4307
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Monitoring patient vital signs is one of many important tasks for health care professionals in intensive care units and anaesthesia departments. Patient status can deteriorate in seconds, hence close surveillance is requisite for safe care. However, monitoring vital signs can be challenging in some situations. Smart glasses have been suggested for facilitating the monitoring of vital signs. To be useful, smart glasses require a customised application and must be integrated in the interacting work system. A work system comprises Person(s), Tasks, Technology and Tools, Organisation, and Environment. The work system affects care processes and outcomes, and one outcome is patient safety. 

The overall aim of this thesis was to investigate health care professionals’ views on and experiences of smart glasses, as well as whether smart glasses could influence patient safety in complex care environments. Five studies were conducted to answer the overall aim. A scoping review compiled previous research about smart glasses in complex care environments (Study I). Through focus group interviews, health care professionals’ views on smart glasses were collected (Studies II and III). Software developers used the knowledge generated to develop a smart glass application for vital signs monitoring. In individual interviews health care professionals shared their experiences’ using smart glasses for vital signs monitoring during clinical anaesthesia care (Study V). A database study was also conducted to describe burden of care related to monitoring (Study IV). The results were synthesised using SEIPS 2.0. 

The results presented in this thesis show that smart glasses can be used to monitor vital signs, and that they made it possible to monitor vital signs regardless of location. However, using smart glasses for vital signs monitoring requires further development to meet clinical needs. The complexity of care in intensive care units and at anaesthesia departments was evident, as were health care professionals’ responsibilities and their commitment to providing safe care for patients. 

This thesis concludes that adding smart glasses to the work system will affect other components of the work system and hence also processes and outcomes such as patient safety. Providing safe care for patients in complex care environments is challenging. The patient’s best is health care professionals’ highest priority, hence health care professionals are an asset for patient safety. To have positive impact on patient safety, new tools such as smart glasses must be designed to fit into the rest of the work system and to facilitate health care professionals’ work processes.

Place, publisher, year, edition, pages
Karlskrona: Blekinge Tekniska Högskola, 2022. , p. 127
Series
Blekinge Institute of Technology Doctoral Dissertation Series, ISSN 1653-2090 ; 8
Keywords [en]
Anesthesia Department, Hospital; Human Factors Engineering; Intensive Care Units; Monitoring, Physiologic; Nursing; Smart Glasses; Patient Safety.
National Category
Medical and Health Sciences Nursing
Research subject
Applied Health Technology
Identifiers
URN: urn:nbn:se:bth-23754ISBN: 978-91-7295-445-8 (print)OAI: oai:DiVA.org:bth-23754DiVA, id: diva2:1703812
Public defence
2022-12-09, J1630, Karlskrona, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2022-10-17 Created: 2022-10-14 Last updated: 2022-11-09Bibliographically approved
List of papers
1. Smart glasses for caring situations in complex care environments: Scoping review
Open this publication in new window or tab >>Smart glasses for caring situations in complex care environments: Scoping review
2020 (English)In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 8, no 4, article id e16055Article, review/survey (Refereed) Published
Abstract [en]

Background: Anesthesia departments and intensive care units represent two advanced, high-tech, and complex care environments. Health care in those environments involves different types of technology to provide safe, high-quality care. Smart glasses have previously been used in different health care settings and have been suggested to assist health care professionals in numerous areas. However, smart glasses in the complex contexts of anesthesia care and intensive care are new and innovative. An overview of existing research related to these contexts is needed before implementing smart glasses into complex care environments. Objective: The aim of this study was to highlight potential benefits and limitations with health care professionals' use of smart glasses in situations occurring in complex care environments. Methods: A scoping review with six steps was conducted to fulfill the objective. Database searches were conducted in PubMed and Scopus; original articles about health care professionals’ use of smart glasses in complex care environments and/or situations occurring in those environments were included. The searches yielded a total of 20 articles that were included in the review. Results: Three categories were created during the qualitative content analysis: (1) smart glasses as a versatile tool that offers opportunities and challenges, (2) smart glasses entail positive and negative impacts on health care professionals, and (3) smart glasses' quality of use provides facilities and leaves room for improvement. Smart glasses were found to be both a helpful tool and a hindrance in caring situations that might occur in complex care environments. This review provides an increased understanding about different situations where smart glasses might be used by health care professionals in clinical practice in anesthesia care and intensive care; however, research about smart glasses in clinical complex care environments is limited. Conclusions: Thoughtful implementation and improved hardware are needed to meet health care professionals’ needs. New technology brings challenges; more research is required to elucidate how smart glasses affect patient safety, health care professionals, and quality of care in complex care environments. ©Charlotte Romare, Lisa Skär.

Place, publisher, year, edition, pages
JMIR Publications, 2020
Keywords
Anesthesia department, Critical care, Intensive care units, Scoping review, Smart glasses
National Category
Nursing
Identifiers
urn:nbn:se:bth-19439 (URN)10.2196/16055 (DOI)000526813600001 ()32310144 (PubMedID)2-s2.0-85083801154 (Scopus ID)
Note

Open access

Funded by the Scientific Council at Region Blekinge.

Available from: 2020-05-08 Created: 2020-05-08 Last updated: 2022-10-14Bibliographically approved
2. Healthcare professionals' views of smart glasses in intensive care: A qualitative study
Open this publication in new window or tab >>Healthcare professionals' views of smart glasses in intensive care: A qualitative study
2018 (English)In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 45, p. 66-71Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to describe healthcare professionals' views of smart glasses before their implementation in an intensive care unit, both regarding quality of use of the glasses and to identify possible intensive care situations where the glasses could be used to increase patient safety. Methods: Data were generated through focus group interviews and analysed using thematic content analysis. Findings: The findings describe participants' views of smart glasses divided into three categories; Smart glasses to facilitate work at intensive care unit; Quality of use and Utilisation. Participants assumed smart glasses to cause both effect and affect in intensive care. Participants' concern for patients arose recurrently and through their concern intention to work to promote patient safety. Conclusion: Smart glasses are suggested as a complement to existing monitoring and routines and cannot replace human presence in intensive care. © 2017 The Authors.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Critical care, Focus groups, Intensive care units, Monitoring physiologic, Patient safety, Patient-centred care, Qualitative research, Smart glasses, Surveillance
National Category
Nursing
Identifiers
urn:nbn:se:bth-15738 (URN)10.1016/j.iccn.2017.11.006 (DOI)000427792500012 ()2-s2.0-85039550176 (Scopus ID)
Available from: 2018-01-11 Created: 2018-01-11 Last updated: 2022-10-14Bibliographically approved
3. Smart Glasses for Anesthesia Care: Initial Focus Group Interviews with Specialized Health Care Professionals
Open this publication in new window or tab >>Smart Glasses for Anesthesia Care: Initial Focus Group Interviews with Specialized Health Care Professionals
Show others...
2021 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 36, no 1, p. 47-53Article in journal (Refereed) Published
Abstract [en]

Purpose: Smart glasses are a kind of wearable technology that gives users sustained, hands-free access to data and can transmit and receive information wirelessly. Earlier studies have suggested that smart glasses have the potential to improve patient safety in anesthesia care. Research regarding health care professionals' views of the potential use of smart glasses in anesthesia care is limited. The purpose of this study was to describe anesthesia health care professionals' views of smart glasses before clinical use. Design: A qualitative descriptive study. Methods: Data were collected from focus group interviews and analyzed using thematic content analysis. Findings: Three categories of participants' views of smart glasses were created during the analysis: views of integrating smart glasses in clinical setting; views of customized functionality of smart glasses; and views of being a user of smart glasses. One theme, striving for situational control, was identified in the analysis. Conclusions: Smart glasses were seen as a tool that can impact and improve access to patient-related information, and aid health care professionals in their struggle to gain situational control during anesthesia care. These are factors related to increased patient safety. (c) 2020 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC, 2021
Keywords
anesthesia, smart glasses, physiological monitoring, patient safety, qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:bth-21367 (URN)10.1016/j.jopan.2020.06.019 (DOI)000635450700010 ()33041201 (PubMedID)2-s2.0-85092252548 (Scopus ID)
Note

open access

Available from: 2021-04-29 Created: 2021-04-29 Last updated: 2022-10-14Bibliographically approved
4. Burden of care related to monitoring patient vital signs during intensive care; a descriptive retrospective database study
Open this publication in new window or tab >>Burden of care related to monitoring patient vital signs during intensive care; a descriptive retrospective database study
2022 (English)In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 71, article id 103213Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to describe burden of care related to monitoring patient vital signs of intensive care unit patients in a Swedish hospital. Setting: Data collected by “The Swedish Intensive Care Registry” from one general category II intensive care unit in a Swedish hospital was included in this study. Data from year 2014 to 2020 was analysed comprising a total of 3617 intensive care episodes and 29,165 work shifts. Research methodology: This is a retrospective database study. Descriptive statistics gave an overview of the dataset. To test for differences between variables related to burden of care for “Documentation of monitoring” Mann Whitney U test and Kruskal Wallis test was performed using STATA. Results: “Documentation of monitoring” was reported to generate a prominent burden of care during intensive care. Nearly all patients had continuous monitoring. Comparison for burden of care related to “Documentation of monitoring” for sexes generated no statistically significant difference. Comparison for burden of care related to “Documentation of monitoring” among age groups, diagnose groups and time of day generated statistically significant differences. Conclusion: Monitoring patient vital signs was clearly present during intensive care, hence impacting intensive care nurses’ clinical practice. Further research is endorsed to improve and facilitate monitoring to keep improving patient safety. © 2022 The Authors

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Critical care, Intensive care units, Monitoring physiologic, Nursing, Vital signs, Workload, adult, article, clinical practice, controlled study, documentation, drug safety, female, groups by age, human, intensive care, intensive care unit, Kruskal Wallis test, major clinical study, male, nurse, patient safety, rank sum test, retrospective study, vital sign
National Category
Nursing
Identifiers
urn:nbn:se:bth-22715 (URN)10.1016/j.iccn.2022.103213 (DOI)000836189200001 ()2-s2.0-85124811308 (Scopus ID)
Note

open access

Available from: 2022-03-07 Created: 2022-03-07 Last updated: 2022-10-14Bibliographically approved
5. Nurse anesthetists’ experiences using smart glasses to monitor patients’ vital signs during anesthesia care: A qualitative study
Open this publication in new window or tab >>Nurse anesthetists’ experiences using smart glasses to monitor patients’ vital signs during anesthesia care: A qualitative study
Show others...
2021 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 4 April, article id e0250122Article in journal (Refereed) Published
Abstract [en]

Purpose To describe nurse anesthetists’ experiences using smart glasses to monitor patients’ vital signs during anesthesia care. Methods Data was collected through individual semi-structured interviews with seven nurse anesthetists who had used smart glasses, with a customized application for monitoring vital signs, during clinical anesthesia care. Data was analyzed using thematic content analysis. Results An overarching theme became evident during analysis; Facing and embracing responsibility. Being a nurse anesthetist entails a great responsibility, and the participants demonstrated that they shouldered this responsibility with pride. The theme was divided in two sub-themes. The first of these, A new way of working, comprised the categories Adoption and Utility. This involved incorporating smart glasses into existing routines in order to provide safe anesthesia care. The second sub-theme, Encountering side effects, consisted of the categories Obstacles and Personal affect. This sub-theme concerned the possibility to use smart glasses as intended, as well as the affect on nurse anesthetists as users. Conclusion Smart glasses improved access to vital signs and enabled continuous monitoring regardless of location. Continued development and improvement, both in terms of the application software and the hardware, are necessary for smart glasses to meet nurse anesthetists’ needs in clinical practice. Copyright: © 2021 Romare et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Place, publisher, year, edition, pages
Public Library of Science, 2021
Keywords
GOOGLE GLASS; INTENSIVE-CARE; SAFETY; TECHNOLOGY; DISPLAYS; SURGERY; IMPACT
National Category
Nursing
Identifiers
urn:nbn:se:bth-21384 (URN)10.1371/journal.pone.0250122 (DOI)000644133400015 ()2-s2.0-85104496783 (Scopus ID)
Note

open access

Available from: 2021-05-07 Created: 2021-05-07 Last updated: 2022-10-14Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
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  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
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  • asciidoc
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