Continuous Vital Sign Monitoring on the Surgical Ward

How the REQUEST Study at Catharina Hospital Eindhoven Reduced Nursing Workload

The Challenge of Manual Spot Check Monitoring on General Wards

Monitoring vital signs is essential for detecting postoperative complications early and safeguarding patient recovery on surgical wards. In daily practice, however, monitoring still relies heavily on manual spot checks, typically three per day by nurses and combined into an Early Warning Score (EWS).

While essential for clinical decision-making, this approach has clear limitations. It is labor-intensive, provides only intermittent snapshots of a patient’s condition, and offers limited visibility into patient status between measurements. In addition, adherence can vary between wards and hospitals. As a result, nurses spend valuable time performing routine manual measurements, while clinical teams lack continuous insight into potential deterioration.

The pressure of manual vital sign monitoring becomes especially visible during busy morning shifts. A nurse from the post-surgical department at Catharina Hospital Eindhoven (CZE) described:

The morning shift starts at 7 a.m., and that used to be a rush to get everything done for the doctor's visit. We had to get eight patients out of bed, provide morning care, hand out medications, and do all the check-ups manually. Sometimes it just didn't work out to finish everything on time, so patients had to stay in bed longer and could be mobilized later.

This reflects a structural challenge in postoperative ward care: delivering timely monitoring while preserving time for direct patient care.

The REQUEST Study: Continuous Monitoring in Routine Surgical Care

To address the above challenges, Catharina Hospital Eindhoven conducted the REQUEST implementation study, evaluating the real-world integration of continuous vital sign monitoring using the reusable viQtor wearable, fully integrated into the electronic medical record (EMR). This study assessed whether continuous monitoring, embedded into daily surgical ward workflows, impact nursing workload, usability, and routine care delivery.

Over a 9-month period, this prospective study included:

• 30 nurses participating in workload and usability assessments.
• 622 patients monitored as part of routine surgical care.
• Multidisciplinary collaboration between nursing staff, physicians, and ICT teams.
• The viQtor wearable continuously measured three key vital signs: pulse rate, respiratory rate, and oxygen saturation. Measurements were computed into four-hour median values and automatically sent to the EMR for clinical review.

Results: Reduced Workload and High Usability

The REQUEST study demonstrated measurable impact after implementation of EMR-integrated continuous monitoring with viQtor:

• A significant reduction in perceived nursing workload (Integrated Workload Scale (IWS) 5.46 → 3.87).
• A 62.7% reduction in manual vital sign spot checks.
• Saving approximately 10 minutes per patient per day, resulting in 263 nursing hours over the 9-month study period.
• Excellent usability among both nurses and patients (System Usability Scale: 86.0).
• Increasing acceptance and integration into daily routines.

Importantly, continuous monitoring with viQtor , augmented existing clinical workflows. Wearable data was reviewed alongside traditional EWS, supporting timely and informed decisions while reducing repetitive manual measurements.
After implementation, when continuous wearable monitoring became standard practice on the surgical ward, the same nurse reflected:

Now that we are working with viQtor, the vital sign checks are already in the EMR. As a result, we can mobilize patients faster and feel less rushed during morning care. We are ready in time for the doctor's visit, because we no longer have to do manual check-ups in the morning. That gives us more time for personal care. This benefits the quality of care, because we can mobilize patients earlier, and that contributes to a faster recovery.

Advancing Postoperative Care Through EMR-Integrated Monitoring

The REQUEST study at Catharina Hospital Eindhoven demonstrates that EMR-integrated continuous monitoring with the reusable viQtor wearable device is feasible in routine surgical care. By automating vital sign acquisition while maintaining clinical oversight, wearable monitoring reduces nursing workload, improves efficiency of postoperative care delivery, enabled more patient-centered care and time for direct patient interaction, and supports early detection of deterioration.

In a healthcare environment facing rising demands and workforce pressure, continuous monitoring solutions that reduce workload while preserving patient safety represent a meaningful and scalable step forward.

The full study is published in the World Journal of Surgery:
Remote Monitoring With a Reusable Device Upon Implementation on a Surgical Department (REQUEST Trial)