'There were more wires than him': the potential for wireless patient monitoring in neonatal intensive care

Abstract

Background: The neonatal intensive care unit (NICU) can be one of the most stressful hospital environments. Alongside providing intensive clinical care, it is important that parents have the opportunity for regular physical contact with their babies because the neonatal period is critical for parent-child bonding. At present, monitoring technology in the NICU requires multiple wired sensors to track each baby's vital signs. This study describes the experiences that parents and nurses have with the current monitoring methods, and reports on their responses to the concept of a wireless monitoring system.

Methods: Semistructured interviews were conducted with six parents, each of whom had babies on the unit, and seven nurses who cared for those babies. The interviews initially focused on the participants' experiences of the current wired system and then on their responses to the concept of a wireless system. The transcripts were analysed using a general inductive approach to identify relevant themes.

Results: Participants reported on physical and psychological barriers to parental care, the ways in which the current system obstructed the efficient delivery of clinical care and the perceived benefits and risks of a wireless system. The parents and nurses identified that the wires impeded baby-parent bonding; physically and psychologically. While a wireless system was viewed as potentially enabling greater interaction, staff and parents highlighted potential concerns, including the size, weight and battery life of any new device.

Conclusions: The many wires required to safely monitor babies within the NICU creates a negative environment for parents at a critical developmental period, in terms of physical and psychological interactions. Nurses also experience challenges with the existing system, which could negatively impact the clinical care delivery. Developing a wireless system could overcome these barriers, but there remain challenges in designing a device suitable for this unique environment.

Keywords: kangaroo care; neonatal intensive care; patient monitoring; wireless sensors.

Figure 1

The neonatal care environment. The display in the top left visualises the vital sign signals from the ECG probes, pulse oximeter cuff and the temperature sensor. The unit in the bottom right is a non-invasive ventilator. The incubator provides a thermally (and, if required, humidity) regulated environment for the baby.

Figure 2

A premature baby inside an incubator in the neonatal intensive care unit. The sticker attached to the chest is one of three ECG probes. A pulse oximeter cuff is secured to the foot, and a temperature probe is attached to the baby's back. The nasal tubing provides non-invasive ventilation.