Protocol for a Prospective Implementation Study

Published in JMIR Research Protocol - 2025

Abstract


Background

Continuous monitoring of patients’ vital signs is critical for early detection of postoperative complications. Traditional manual monitoring by nursing staff is time-consuming and provides only intermittent data. Wearable devices offer continuous monitoring capabilities, potentially enhancing early warning systems, reducing nurse workload, and facilitating earlier patient discharge. However, research on their implementation and effectiveness in clinical settings remains limited.

Objective
This study aims to evaluate the implementation and feasibility of continuous monitoring using photoplethysmography sensor technology (a viQtor device) in a surgical ward. We will also assess the impact on nursing workload and the usability of this workflow.

Methods
The REQUEST (Remote Monitoring by viQtor Upon Implementation on a Surgical Department) study is a prospective observational implementation study conducted over 8 months in a surgical ward. The vital signs of 500 postoperative patients will be continuously monitored using the viQtor device, which measures heart rate, respiratory rate, and oxygen saturation. The study consists of 2 phases: an initial period with manual spot checks, followed by a phase using the wearable device as the primary monitoring tool. Outcomes include the Integrated Workload Scale for nursing workload and a framework evaluating acceptability, feasibility, adoption, and sustainability. Data collection involves device performance metrics, questionnaires (the Evidence-Based Practice Attitude Scale and the System Usability Scale), and thematic analysis of focus groups.

Results
Staff training was completed in October 2024, and full implementation is ongoing. Preliminary findings, including data on usability and workload, are expected by July 2025. Conclusions: This study will provide insight into the practical implementation of continuous vital sign monitoring in surgical care. The findings may support future adoption of wearable technology in clinical workflows.

Trial Registration
ClinicalTrials.gov NCT06574867; https://clinicaltrials.gov/study/NCT06574867 International Registered Report Identifier (IRRID): DERR1-10.2196/70707

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