Impact assessment of new sick clothes in patients with electrocardiogram monitoring / 中华危重病急救医学

ABSTRACT

Objective To design a new modified sick clothes for electrocardiogram (ECG) monitoring, and to observe its clinical application effect. Methods In order to overcome the shortcomings of the existing modified ECG monitoring clothes, a new type of modified sick clothes was designed on the basis of the traditional sick clothes, and a national utility model patent was obtained. 408 conscious patients with ECG monitoring admitted to department of neurology of the First Affiliated Hospital of Fujian Medical University from January 2015 to June 2018 were enrolled, and they were randomly divided into three groups according to the order of admission for comparing the wearing effect of three kinds of sick clothes. 133 patients dressed traditional clothes, while 139 patients dressed modified ECG monitoring clothes. According to the method reported in the literature, the pockets were removed on the basis of the traditional patient clothes, and a circular hole 5 cm in diameter was made at the position of the electrodes for ECG monitoring, which was used to pass through the lead wire and the electrodes. 136 patients dressed the new modified sick clothes. In view of the inconvenience of ECG monitoring and stimulation of patients' thoracic and abdominal skin by traditional sick clothes, the existing modified ECG monitoring clothes were not easy to operate, the location of electrodes sticking was not easy to judge and the lead line was messy, the new modified sick clothes were still based on the traditional ones. The three circular holes of the existing modified ECG monitoring clothes were made into incisions about 12 cm in length to facilitate the ECG monitoring lead line and electrodes sticking. A compression band or a simple patch was added to each side near the shoulder for tidying up the fixed lead. The self-evaluation of patient's comfort, the operation time of ECG monitoring by nurses, skin allergy rate and lead damage rate were recorded and compared among the three groups. Results Compared with the traditional sick clothes and the modified ECG monitoring clothes groups, the patients in the new modified sick clothes group had higher comfort [the proportion of no discomfort 11.0% (15/136) vs. 0% (0/133), 5.8% (8/139); the proportion of severe discomfort 0% (0/136) vs. 4.5% (6/133), 0.7% (1/139), all P < 0.05], the installation and disassembly time of ECG monitoring by nurses was significantly shortened [installation time (s) 69.12±16.47 vs. 96.74±3.89, 88.24±9.83; disassembly time (s) 50.24±4.54 vs. 75.76±4.98, 66.54±7.86, all P < 0.01], and the skin allergies rate [3.7% (5/136) vs. 15.8% (21/133), 8.6% (12/139)] and the insulation loss rate of the lead wires [2.9% (4/136) vs. 15.8% (21/133), 7.9% (11/139)] were significantly lowered (all P < 0.05). Conclusion The ECG monitoring patients using new modified sick clothes could increase their comfort, reduce the workload of nurses, save medical consumables, and have beautiful appearance and high practicability, which was worthy of clinical application.