Table 7 Staff, patient and carer post-implementation experiences of Vision-Based Patient Monitoring and Management (VBPMM)
Vision-Based Patient Monitoring & Management (VBPMM)​ | Post-implementation experiences of surveillance​ | MMAT quality rating​ | Conflicts of interest​ | |
|---|---|---|---|---|
Perceived benefits​ | • Positive effect on patients’ sleep​. • Enables less intrusive monitoring, reducing the risk of aggressive behaviour escalating, and improving patient/staff relationships. • Observations easier and quicker for staff​. • Perceived reduction in verbal and physical aggression.​ • Knowing location of patients thought to help staff manage large wards. • Graphical reports provide an overview a patients’ day and/or night level of activities, providing a snapshot of acuity which can be useful in staff handovers and help staff better plan daytime activities. • Perceived improvement to patients’ privacy and dignity when compared to in person observation​. • Provides patients with a greater sense of agency for their safety. • Technology helps identify, prevent and mitigate incidents​, reducing restrictive interventions. • Leads to better care for patients​. • Improved staff and patient safety. • Improved assurance for staff managing risk. • Can serve as an extra safety measure when staff were unable to perform physical checks on a patient (e.g. if they were behaving aggressively). • Improved physical health monitoring aiding clinical decision making​. | 4 × low 1 × high | 4/5 papers reported a conflict of interest | |
• Feeling safer as monitoring leads to staff helping quicker if their health worsens​. • Technology aids independence from staff​. • Better nights’ sleep with remote monitoring (as physical checks disturbed sleep)​. • Monitoring in seclusion aided feeling connected to others.​ • Some patients feel indifferent about the technology’s use, for example, over time forgetting that it was there, paying less attention to it, and accepting that it was there to stay. | 2 × low 1 × high​ | 2/3 papers reported a conflict of interest | ||
Carers (n = 1 paper [40]) | • Carers had mostly positive perceptions of monitoring. | Low​ | Yes | |
Negative impacts, effects and harms | Staff (n = 1 paper [32])​ | • Technological glitches (e.g. poor Wi-Fi, signal issues, poor readings of patient activity)​. • Security concerns; data protection and physical concerns about the device e.g. concerns about patients accessing VBPMM data via the code on the back of staff’s iPads. • Lack of trust in the technology's accuracy.​ • Insufficient training to be able to use the technology correctly, and issues with staff ability to use the technology​. • Technology not a replacement for standard care and physical observations​. • Negative effect on patients’ privacy including ethical concerns regarding watching patients. | High | None |
Patients (n = 1 paper [32]) | • Lack of privacy and dignity felt when monitored​. • Concerns regarding the impact on human rights. • Feelings of embarrassment, distress and paranoia regarding being watched (particularly around getting undressed)​. • Lack of choice or say about the use of the technology​. • Less trust in staff and impact on relationships with staff​. • Increased power imbalance between staff and patients​. • Lack of communication about the technology, including inaccuracies in explanations. •Negative perceptions more common amongst patients who had spent less time in hospital. | High | None | |
Carers (n = 1 paper [40])​ | • Concerns regarding the negative impact on quality of care. | Low | Yes | |