Stepdown units (SDUs) allow for noninvasive, continuous monitoring of high-acuity patients' vital signs while freeing up ICU
beds and staff in acute-care facilities. When SDU patients experience emergencies such as cardiorespiratory instability, this
monitoring permits rapid medical emergency team (MET) intervention. But the sensitivity and reliability of monitoring—which
in some facilities relies on manual interpretation during rounds before METs are called—are not fully understood. In a new
University of Pittsburgh study, researchers added integrated monitoring systems to SDU patients' bedside arrays, with the
goal of combining all patient vital-sign data into a single BioSign Index (BSI). SDU data then were compared to MET activation
events to determine whether they were preceded by significant declines in patients' BSI scores. Researchers found that patient
BSIs correctly predicted all events requiring MET intervention, due to more sensitive detection of early instability. The
study highlighted the inefficiency of relying on manual rounds for data review and bedside observation, and the inaccuracy
of relying on a single data source or parameter versus the multiple sources in the unified BSI value.
Hravnak, M., et al. (2008). Defining the incidence of cardiorespiratory instability in patients in stepdown units using an
electronic integrated monitoring system. Arch Int Med 168(12), 1300.
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