RESUMO
INTRODUCTION: Intravenous infusion therapy is a common and challenging invasive treatment procedure in hospital wards. Administration mistakes can have serious, even life-threatening, consequences. The Monidor solution was developed to help nurses administer gravity-based infusions and monitor them remotely, to avoid complications and reduce workload. Its real-world effects and economic consequences were unknown. METHODS: An exploratory survey was carried out to estimate the potential impact of the Monidor solution on events and nurse time use. At the end of their shift, nurses estimated effects in terms of routine room visits avoided, prevention of complications, and impact on nurse time requirements. Linear regression was applied to estimate predictors of time freed. A health economic model was developed to evaluate economic consequences and to calculate the net return on investment for a hypothetical hospital ward. A 1-month time horizon was used, and discounting was not applied. RESULTS: A total of 216 responses were obtained from 6 Finnish hospitals, from a total of 15 wards, and 56.3% of nurses found that the Monidor solution freed nurse time, while < 3.5% experienced additional time requirements. Per nurse shift, the Monidor solution avoided on average 2.064 routine room visits, helped detect end of infusion 1.340 times, and led to 5.045 min of time freed. One routine visit avoided was associated with 2.453 min of time freed in the linear regression. In the conservative setting, the freed monthly capacity in the hypothetical ward amounted to 1270.90 per month (year 2021), yielding a return on investment of 2.63. Uncertainty of linear regression coefficient values was identified as a driver of uncertainty in sensitivity analysis, with return on investment ranging from 1.55 to 3.71. CONCLUSIONS: The study demonstrated that management and remote monitoring with the Monidor solution frees nurse time and reduces routine activities associated with gravity-based intravenous infusions. These findings could be confirmed in a comparative empirical study.
In hospitals, patients often receive fluids intravenously. These fluids enter the blood circulation directly, and their incorrect administration (too much or too little, too slow or too fast) can have serious and potentially life-threatening consequences. The Monidor solution aims to improve administration of intravenous fluids. It consists of two components: a mobile app for remote monitoring and a meter for bedside management. This study aimed to estimate the impact of the Monidor solution on administration of intravenous fluids and to assess how the Monidor solution would affect costs. Among the factors considered were the price of the devices, nurse time freed, and prevention of complications with the intravenous therapies. The data were collected via questionnaires from nurses from 15 wards in 6 Finnish hospitals. According to the responses and a health economic model designed for this study, the Monidor solution freed capacity with a value of 1270.90 per month. When considering the local cost of the Monidor solution, the return on investment was positive. In summary, the Monidor solution is cost-effective; routine room visits by nurses were avoided, problems with infusions were detected earlier, and nurse time was freed. These findings could be confirmed in a larger study.
