Inter-rater reliability supports data validation

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Curiato's first clinical abstract has been accepted for the Symposium on Advanced Wound Care (SAWC). The study is authored by Dr. Nicola Waters with title Feasibility of a Novel Smart Surface System for Monitoring Patients at risk of Pressure Injuries in a Post-Acute Care Facility.

Significance: Interface pressure (IP) and skin microclimate have been identified as critical risk parameters for pressure injury development (PI). Continuous monitoring of these parameters by nursing observation is impossible. Protocols that rely solely on intermittent physical assessment via observation of patient mobility, temperature and humidity limit care providers’ ability to identify risk levels, deliver personalized care and measure the effectiveness of interventions.

Objective: To compare continuous sensor monitoring by a non-invasive smart surface to nurses’ intermittent physical assessment of parameters related to skin integrity. 

Methods: This prospective, single-site trial was conducted at a tertiary care facility in a large urban center in Canada. Patients identified at risk of PIs received standard of care while placed on the smart surface for a timed interval. Nurses’ assessment data were collected at 3-hourly time points using a comprehensive tool developed for the study. Sensors monitored patients’ IP, relative humidity, and surface temperature every 5 seconds. A comparative statistical analysis was conducted between the two datasets.

Results: A total of 104 patients met the inclusion criteria. Mean age was [59] years (range 21-92, SD 19.15). The 1,407 sensor monitoring hours generated 1,101,780 frames of surface data. Nurse observations totaled 370 assessments. Sensor-generated data correlated strongly with the nurse collected data at cross-sectional intervals. Additional longitudinal computer data included IP during and immediately after assisted turns, activity and mobility between assessments, and time-specific alterations in temperature and relative humidity (e.g., incontinence events).

Implications: The technology’s ability to accurately measure PI risk factors supports nursing practice. Continuous monitoring generates supplementary data that has the potential to improve resource allocation by informing targeted strategies to manage skin microclimate and decrease unnecessary interventions. The large volume of data collected will be used as a basis for future AI applications with the potential to inform other clinical decision-making areas.

 

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