Wearable and wireless continuous monitoring for early detection of clinical deterioration in high-risk inpatients: a scoping review

Abstract

Objectives Delayed recognition of clinical deterioration leads to both clinical and economic burdens. Manual monitoring by nurses with Early Warning Scores (EWS) remains relevant, but its intermittent nature limits timely detection of sudden or evolving changes. Wearable wireless devices capable of continuous monitoring offer a potential solution. This scoping review examines current evidence on the use and relevance of such biosensors in patients at risk of deterioration. Methods Articles were identified through PubMed, Embase, Medline, and Health Technology Assessment databases. We included studies describing the use of wearable devices for early detection of clinical deterioration in hospitalised high-risk adults on general wards or intermediate care units. Eligible study types comprised validation studies, evaluations of clinical and non-clinical outcomes, and experience measures. Results Fourteen different devices were evaluated across 25 studies conducted in five countries: the Netherlands, the United States, Denmark, Israel, and Brazil. With few exceptions, continuous monitoring of vital signs was reported to be associated with improvements on in-hospital mortality, intensive care unit admissions, and rapid response team (RRT) activations, hospital length of stay, clinical deterioration and adverse events, cumulative duration of vital sign deviations. Patient and nurse acceptability were assessed in qualitative studies using questionnaires and/or interviews. Overall, patients expressed greater willingness to wear a sensor compared to nurses’ readiness to adopt the technology in their clinical practice. Conclusions Taken together, the reviewed literature suggests that wearable wireless devices can positively impact healthcare quality and patient safety. However, while patients generally demonstrate high acceptance of such devices, nurses appear more hesitant to integrate them into routine care. Implications for clinical practice Successful implementation requires optimising alarm management, improving device reliability, and providing adequate training and workflow integration to support nurses in adopting continuous monitoring within routine clinical practice.