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Real-Time Remote Health-Monitoring Systems in a Medical Centre: A Review of the Provision of Healthcare Services-Based Body Sensor Information, Open Challenges and Methodological Aspects

Albahri OS, Zaidan AA, Zaidan BB, Hashim M, Albahri AS, Alsalem MA

J Med Syst, 2018 Jul 25;42(9):164.
PMID: 30043085 DOI: 10.1007/s10916-018-1006-6

Promoting patient care is a priority for all healthcare providers with the overall purpose of realising a high degree of patient satisfaction. A medical centre server is a remote computer that enables hospitals and physicians to analyse data in real time and offer appropriate services to patients. The server can also manage, organise and support professionals in telemedicine. Therefore, a remote medical centre server plays a crucial role in sustainably delivering quality healthcare services in telemedicine. This article presents a comprehensive review of the provision of healthcare services in telemedicine applications, especially in the medical centre server. Moreover, it highlights the open issues and challenges related to providing healthcare services in the medical centre server within telemedicine. Methodological aspects to control and manage the process of healthcare service provision and three distinct and successive phases are presented. The first phase presents the identification process to propose a decision matrix (DM) on the basis of a crossover of 'multi-healthcare services' and 'hospital list' within intelligent data and service management centre (Tier 4). The second phase discusses the development of a DM for hospital selection on the basis of integrated VIKOR-Analytic Hierarchy Process (AHP) methods. Finally, the last phase examines the validation process for the proposed framework.

Matched MeSH terms: Vital Signs
Fulltext The primary health care performance initiative (PHCPI): Issues and challenges for Malaysia as a trailblazer country

Anis Safura Ramli, Sri Wahyu Taher, Zainal Fitri Zakaria, Norsiah Ali, Nurainul Hana Shamsuddin, Wong Ping Foo, et al.

Journal of Clinical and Health Sciences, 2019;4(1):4-21.
MyJurnal

A strong and robust Primary Health Care system is essential to achieving universal health
coverage and to save lives. The Global Conference on Primary Health Care 2018: from Alma-Ata towards achieving Universal Health Coverage and the Sustainable Development Goals at
Astana, Kazakhstan provided a platform for low‐ and middle‐ income countries to join the
Primary Health Care Performance Initiative (PHCPI). At this Global Conference, Malaysia has
declared to become a Trailblazer Country in the PHCPI and pledged to monitor her Vital Signs
Profiles (VSP). However, the VSP project requires an honest and transparent data collection
and monitoring of the Primary Health Care system, so as to identify gaps and guide policy in
support of Primary Health Care reform. This is a huge commitment and can only be materialised
if there is a collaborative partnership between Primary Care and Public Health providers.
Fundamental to all of these, is the controversy concerning whether or not ‘Primary Care’ and
‘Primary Health Care’ represent the same entity. Confusion also occurs with regards to the role
of ‘Primary Care’ and ‘Public Health’ providers in the Malaysian Primary Health Care system.
This review aims to differentiate between Primary Care, Primary Health Care and Public Health,
describe the relationships between the three entities and redefine the role of Primary Care and
Public Health in the PHCPI-VSP in order to transform the Malaysian Primary Health Care
system.

Matched MeSH terms: Vital Signs
Physical assessment skills practised by critical care nurses: A cross-sectional study

Rosli SN, Soh KL, Ong SL, Halain AA, Abdul Raman R, Soh KG

Nurs Crit Care, 2023 Jan;28(1):109-119.
PMID: 35023244 DOI: 10.1111/nicc.12748

BACKGROUND: Physical assessment skills are essential to clinical decision-making in nursing as they help nurses to identify and respond to patients' deterioration. Nurses develop confidence and can detect any out-of-range parameters in diagnosing and treating patients. Prior studies surveyed 120 skills but did not explicitly assess critical care.
AIM: To determine the range of physical assessment skills practised by critical care nurses and their adoption factors.
STUDY DESIGN: This study uses a cross-sectional survey design. A self-administered questionnaire evaluating 40 physical assessment skills was conducted with 133 staff nurses (response rate: 96.4%) in three critical care units at a Malaysian government hospital between November 2019 and January 2020.
RESULTS: Most nurses applied 32 (80%) skills during every working shift, involving the vital signs and all body systems except the gastrointestinal system. Five skills (12.5%) were occasionally applied, while three skills (7.5%) were rarely applied or not part of most nurses' clinical practice. About 20% of the nurses did not routinely check the respiration rate. Medical and surgical intensive care unit nurses (U = 1129, p vital to critical care nursing roles. Concerns highlighted by the nurses should be addressed by nursing management so that the application of physical assessment skills can be enhanced, especially in critical care settings.
RELEVANCE TO CLINICAL PRACTICE: The findings indicated that physical assessment skills in critical care need to be improved. Education and training should emphasise these skills.

Matched MeSH terms: Vital Signs
Fulltext The SPEED (sepsis patient evaluation in the emergency department) score: a risk stratification and outcome prediction tool

Bewersdorf JP, Hautmann O, Kofink D, Abdul Khalil A, Zainal Abidin I, Loch A

Eur J Emerg Med, 2017 Jun;24(3):170-175.
PMID: 26524675 DOI: 10.1097/MEJ.0000000000000344

OBJECTIVES: The aim of the study was to identify covariates associated with 28-day mortality in septic patients admitted to the emergency department and derive and validate a score that stratifies mortality risk utilizing parameters that are readily available.
METHODS: Patients with an admission diagnosis of suspected or confirmed infection and fulfilling at least two criteria for severe inflammatory response syndrome were included in this study. Patients' characteristics, vital signs, and laboratory values were used to identify prognostic factors for mortality. A scoring system was derived and validated. The primary outcome was the 28-day mortality rate.
RESULTS: A total of 440 patients were included in the study. The 28-day hospital mortality rate was 32.4 and 25.2% for the derivation (293 patients) and validation (147 patients) sets, respectively. Factors associated with a higher mortality were immune-suppressed state (odds ratio 4.7; 95% confidence interval 2.0-11.4), systolic blood pressure on arrival less than 90 mmHg (3.8; 1.7-8.3), body temperature less than 36.0°C (4.1; 1.3-12.9), oxygen saturation less than 90% (2.3; 1.1-4.8), hematocrit less than 0.38 (3.1; 1.6-5.9), blood pH less than 7.35 (2.0; 1.04-3.9), lactate level more than 2.4 mmol/l (2.27; 1.2-4.2), and pneumonia as the source of infection (2.7; 1.5-5.0). The area under the receiver operating characteristic curve was 0.81 (0.75-0.86) in the derivation and 0.81 (0.73-0.90) in the validation set. The SPEED (sepsis patient evaluation in the emergency department) score performed better (P=0.02) than the Mortality in Emergency Department Sepsis score when applied to the complete study population with an area under the curve of 0.81 (0.76-0.85) as compared with 0.74 (0.70-0.79).
CONCLUSION: The SPEED score predicts 28-day mortality in septic patients. It is simple and its predictive value is comparable to that of other scoring systems.

Matched MeSH terms: Vital Signs
Fulltext Non-nutritive sucking (nns) and pain response among neonatal

Lia Herliana, Yanti Cahyati

The Malaysian Journal of Nursing, 2019;10(4):83-87.
MyJurnal

Pain is a sensation that is difficult to remember. Pain exposure is a stimulus that can damage the development of the baby's brain and contribute to learning disorders and behavior in childhood. Therefore nursing intervention is needed that can reduce the pain response in infants, especially during hospital treatment. The aim of the study was to determine the effect of non-nutritive sucking (NNS) and ASI (Air Susu Ibu or Breast Milk) on oral responses to acute pain in the neonate when invasive actions were performed. The benefits of research as evidence-based practiced about administering NNS and ASI orally to pain responses in neonates when experiencing pain. The research design uses experimental nonequivalent control group before and after design. The population of all neonates admitted to Dr. Soekardjo Tasikmalaya, with a total sample of 30 respondents consisting of 15 ASI respondents and 15 respondents for the NNS group. Pain assessments instruments CRIES (Crying, Requiring an increase in oxygen, Increased vital sign, Expression, Sleeplessness) was applied. Data analysis used non parametric tests Mann Whitney and Wilcoxon. The results of the study showed no significant differences in pain response before and after the intervention (p-value 0.236). It was suggested that nurses can improve health education for parents to be able to provide breastfeeding during treatment, especially when the baby receives invasive action

Matched MeSH terms: Vital Signs
Systematic Review of Real-time Remote Health Monitoring System in Triage and Priority-Based Sensor Technology: Taxonomy, Open Challenges, Motivation and Recommendations

Albahri OS, Albahri AS, Mohammed KI, Zaidan AA, Zaidan BB, Hashim M, et al.

J Med Syst, 2018 Mar 22;42(5):80.
PMID: 29564649 DOI: 10.1007/s10916-018-0943-4

The new and ground-breaking real-time remote monitoring in triage and priority-based sensor technology used in telemedicine have significantly bounded and dispersed communication components. To examine these technologies and provide researchers with a clear vision of this area, we must first be aware of the utilised approaches and existing limitations in this line of research. To this end, an extensive search was conducted to find articles dealing with (a) telemedicine, (b) triage, (c) priority and (d) sensor; (e) comprehensively review related applications and establish the coherent taxonomy of these articles. ScienceDirect, IEEE Xplore and Web of Science databases were checked for articles on triage and priority-based sensor technology in telemedicine. The retrieved articles were filtered according to the type of telemedicine technology explored. A total of 150 articles were selected and classified into two categories. The first category includes reviews and surveys of triage and priority-based sensor technology in telemedicine. The second category includes articles on the three-tiered architecture of telemedicine. Tier 1 represents the users. Sensors acquire the vital signs of the users and send them to Tier 2, which is the personal gateway that uses local area network protocols or wireless body area network. Medical data are sent from Tier 2 to Tier 3, which is the healthcare provider in medical institutes. Then, the motivation for using triage and priority-based sensor technology in telemedicine, the issues related to the obstruction of its application and the development and utilisation of telemedicine are examined on the basis of the findings presented in the literature.

Matched MeSH terms: Vital Signs