Methodological Quality.

Recent developments make the continuous monitoring of vital signs outside the critical care setting feasible, and may provide a benefit in terms of improved patient outcomes and cost efficiency. A meta-aggregative systematic review was conducted to provide an overview of the experiences of nurses working with continuous monitoring of vital signs in patients admitted to a hospital general ward. All study designs describing nurses’ experiences in a qualitative manner were included. Relevant studies were identified by searching the electronic databases Pubmed, Cinahl and Embase from 2017 up to September 2024. The search strategy combined ‘nurses’, ‘continuous monitoring/measuring’, ‘vital signs’, and ‘hospital/(general) wards’ as well as synonyms. Of 3066 articles found, nine were included. Four themes were synthesized: 1) Emotional and practical advantages, e.g., patients feel safer and nurses feel more secure, as continuous monitoring detects patients deterioration earlier; 2) practical disadvantages, e.g., reduced nurse-patient interaction and stress related to changing vital signs, potential over-monitoring and data overloading; 3) important aspects related to the implementation process, e.g., training and coaching, properly working technical infrastructure; and 4) alarm strategies and clinical assessment, e.g., reducing unnecessary alarms. We conclude that nurses report varying experiences in working with continuous monitoring of vital signs on the general ward. The advantages of continuous monitoring seem to justify investing in further development of the systems and sensors in order to reduce the practical disadvantages. The findings may facilitate optimal implementation of continuous monitoring of vital signs.

近年来的技术进展使得在重症监护病房之外的场景中开展生命体征持续监测成为可行方案，且有望通过改善患者预后与提升成本效益带来临床价值。本研究开展了一项元整合系统综述（meta-aggregative systematic review），旨在全面梳理在普通住院病房接受治疗的患者中，采用生命体征持续监测方案的护理人员的实践体验。本研究纳入所有以定性方法描述护理人员实践体验的研究设计。通过检索2017年至2024年9月期间的PubMed、CINAHL以及Embase电子数据库，筛选出相关研究；检索策略整合了“护理人员”“持续监测/测量”“生命体征”“医院（普通）病房”及其同义词相关关键词。初检共获取3066篇文献，最终纳入9项研究。研究最终归纳提炼出四大主题：1）情感与实践层面的优势：例如，由于持续监测可更早发现患者病情恶化，患者会更具安全感，护理人员也会更安心；2）实践层面的弊端：例如，护患互动时间缩减，与生命体征数据更新相关的工作压力攀升，以及潜在的过度监测与数据过载问题；3）与落地实施流程相关的关键要素：例如培训与指导、稳定运行的技术基础设施；4）警报策略与临床评估：例如减少不必要的警报触发。本研究结论表明，护理人员在普通病房开展生命体征持续监测工作时，其体验存在显著差异。持续监测的优势足以支撑对相关系统与传感器进行进一步研发投入，以缓解其存在的实践层面弊端。本研究结果可为生命体征持续监测方案的优化落地提供参考依据。