Wireless Fetal Monitoring in Labor and Delivery by Rebecca Previte https://padlet.com/RLScottRN/3v088dvrhwf9 by Rebecca Previte en-us 2016-07-19 19:57:22 UTC 2023-02-08 14:54:58 UTC hello@padlet.com Source Details RLScottRN https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116648999 *References are listed below in APA format. All sources are current, within the last 5 years. 

                                                                                                                                                        References
Boatin, A. A., Wylie, B., Goldfarb, I., Azevedo, R., Pittel, E., Ng, C., & Haberer, J. (2015). Wireless Fetal Heart Rate Monitoring in Inpatient Full-Term Pregnant Women: Testing Functionality and Acceptability. PLOS ONE, 10(1), e0117043. doi:10.1371/journal.pone.0117043

Cohen, W. R., & Hayes-Gill, B. (2014). Influence of maternal body mass index on accuracy and reliability of external fetal monitoring techniques. Acta Obstetricia et Gynecologica Scandinavica, 93(6), 590-595. doi:10.1111/aogs.12387

Gardner, G. (2016, July 25). Personal Communication: Email.
 
Monica Healthcare. (2015). Novii Wireless Patch System: Improved Maternal Fetal Monitoring Sales Sheet. Retrieved from: http://www.monicahealthcare.com/Monica_Healthcare/media/Monica/Products/novii_corometrics_products_redarrow.jpg?ext=.jpg

Sameni, R., & Clifford, G. D. (2010). A Review of Fetal ECG Signal Processing; Issues and Promising Directions. The Open Pacing, Electrophysiology & Therapy Journal, 3, 4–20. http://doi.org/10.2174/1876536X01003010004
]]> 2016-07-19 22:36:40 UTC https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116648999 What's the problem!? RLScottRN https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116649188 Currently in Labor & Delivery, the technology used to monitor fetal heart rate and contraction patterns requires the use of Doppler ultrasound (US) transducers and tocodynamometer (TOCO).  Works great... most of the time. So, what's the problem? The higher the body mass index (BMI), the harder to monitor these patterns. The more the patient moves around in bed, the more difficult to monitor. Patients want to take a bath, walk around the unit, but you can't monitor the baby, which is required most of the time. Refusing patient's desires and wishes for their birthing experience decreases patient satisfaction. And, the limits of this technology force clinicians to make important clinical decisions with less accurate data.  Not ok. ]]> 2016-07-19 22:41:44 UTC https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116649188 INFORMATICS TO THE RESCUE! RLScottRN https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116650077 The development of new wireless technology is a perfect example of health care informatics at its best: The development of a technology to improve accuracy and functionality while simultaneously increasing patient and clinician satisfaction! Amazing. ]]> 2016-07-19 22:59:44 UTC https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116650077 Introducing: The Novii Wireless Patch System RLScottRN https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116650365 (Image from: "Novii Wireless Patch System: Improved Maternal Fetal Monitoring Sales Sheet", 2015, p. 4).]]> 2016-07-19 23:05:57 UTC https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116650365 Pros for Novii Wireless Patch System RLScottRN https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116650516 - Effective solution for high BMI patients
- Minimizes risk of maternal/fetal heart rate confusion = improved accuracy
- No repositioning of external monitors
- Cable free = clear, safe work environment
- Increased freedom of movement for patient
- Oh, and its water proof. :)
 
("Novii Wireless Patchy System: Improved Maternal Fetal Monitoring Sales Sheet", 2015, p. 4). ]]> 2016-07-19 23:08:13 UTC https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116650516 Cons for Wireless Monitoring RLScottRN https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116651620 - a complex interface can lead to data loss
- Wifi connection problems = delay in transmission
- Bluetooth won't work due to limited connection range thus requiring 1:1 nursing
(Boatin et al., 2015, p. 10).]]> 2016-07-19 23:24:19 UTC https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116651620 Benefits of wireless monitoring compared to standard RLScottRN https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116651987 - increased mobility
- increased patient freedom
- increased patient satisfaction with labor process
- increased space in labor room for clinicians and birth partners
(Boatin et al., 2015, p. 8).]]> 2016-07-19 23:29:32 UTC https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116651987 THE PILOT STUDY RLScottRN https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116652389 In January 2015, a small study was released examining the use of wireless monitoring. This prototype utilized the US transducers and TOCO to track the fetal heart rate and contraction patterns. The difference? The patient wore these monitors wirelessly and the information was transmitted to a smartphone. From the smartphone, using the internet, to the Cloud, where it could be accessed by clinicians. Some clear benefits were described in addition to some recommendations for improvement. See "Benefits" & "Cons'". 

(Boatin et al., 2015, p. 1).]]> 2016-07-19 23:34:19 UTC https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116652389 The New and Improved...! RLScottRN https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116701480 Because the initial study involved the same technology using ultrasound techniques, clinicians were still limited by a few things: 
1. Elevated BMI
2. Patient positioning
3. Showering/bathing. 
These limitations interfere with the ability to monitor the heart rate pattern & contraction pattern accurately. 
Enter: The Novii Wireless Patch System. ]]> 2016-07-20 15:19:32 UTC https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116701480 How does the Novii work? RLScottRN https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116701683 The Novii uses single use patch adhesives that are applied to the mother's abdomen. The patch uses ECG and EMG electrodes to monitor the fetal heart rate & contraction. The patch connects to the Novii pod- the reusable square part pictured on mom's belly. The pod uses Bluetooth technology to transmit the data to the interface (the black iPad-looking thing at the top). The interface connects directly into the central monitor, which is currently used in practice today. 

("Novii Wireless Patchy System: Improved Maternal Fetal Monitoring Sales Sheet", 2015, p. 3). ]]> 2016-07-20 15:23:31 UTC https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116701683 Questions & Answers from Novii RLScottRN https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116702502 1. Bluetooth- does the patient have to maintain a certain close range for the data to transmit to the interface? This could be a problem for patient's wishing to walk in the hallway outside of their room.
    Answer: Bluetooth ranges 100 feet from the interface unit. Hooray!

2. What kind of internet/wifi connection is necessary to be present on the unit already, if any? 
    Answer: Novii does not use wifi at all. Only Bluetooth that is not discoverable from by other devices. Yay for privacy!

3. Cost: How much does the system cost? What is the cost vs benefit analysis really look like?
     Answer: GE Healthcare distributes these monitors-their price is $6,875 minus applicable health system contracted discounts. 

(G. Gardner, Email, July 25, 2016)

]]> 2016-07-20 15:36:42 UTC https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116702502 New to me! RLScottRN https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116703116 I chose this current innovation because I am a Labor and Delivery nurse of 5 years! In my past work experience, I have utilized wireless monitoring and have noted its limitations: wifi connectivity problems, interference, the need for constant readjustment of the monitors. My current unit has no form of wireless monitoring. However, a representative from Monica Healthcare recently visited the unit to tell us about the Novii system. My manager has requested to purchase two for our unit. Fingers crossed! ]]> 2016-07-20 15:46:22 UTC https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116703116 DID YOU KNOW...!? RLScottRN https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116703739 The fetal heart rate ECG gives a QRS complex much smaller than a maternal ECG shows. Abdominal fetal ECG electrode technology has the ability to differentiate between the two signals. This decreases confusion between maternal tracings and fetal tracing (which happens frequently!). 

(Sameni & Clifford, 2010, p. 9). ]]> 2016-07-20 15:59:11 UTC https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116703739 JURY SAYS... RLScottRN https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116871743 As a L&D nurse, I want this new technology, I need this new technology. Labor is a dynamic process: numerous position changes occur; the plan of care changes; invasive and noninvasive interventions are implemented constantly. I believe we need a versatile technology such as the Novii Wireless Patch System to accommodate the constantly changing variables of labor. While there seem to be some questions or concerns about implementation at a specific unit or facility, I agree with my manager's decision to purchase two systems on a trial basis before acquiring more for our unit. However, I am sure the nurses will be fighting over who gets to use them in no time!]]> 2016-07-24 16:37:09 UTC https://padlet.com/RLScottRN/3v088dvrhwf9/wish/116871743