Monitoring Vitals Made Easy: Designing the perfect tool for nurses

Team: Mykalena Sheldon: UX Researcher, Nate Holmdahl: UI Developer, Zaynah Arif: Product Manager

The Problem

Nurses working on the assisted living floors at Parkshore in Madison Park have extremely busy schedules filled with various tasks. One of these tasks, taking vital signs of residents, is an inefficient process that commonly takes too long and causes a domino effect of time conflicts. By designing a wearable vitals monitor and tracking interface, our solution focuses on making the task of taking vitals more efficient so nurses can focus on helping their patients instead of worrying about diverting time towards this tedious task.

A Comfortable Solution

Our proposed solution is to have residents at Parkshore living facility wear a sock with an integrated vitals monitor placed over the posterior tibial artery that wirelessly transmits vitals information to the nurses and medical databases. This would make the task of taking vitals by hand an emergency measure as the system will alert nurses when a resident is having health issues that are detectable by the monitor. The chance of COVID transmission from a nurse to a resident is minimized by limiting the amount of in-person interaction through contactless monitoring.

The patients wear a comfortable piece of clothing that contains the vitals monitoring device. Depicted in this drawing is a sock, but the technology could be implemented in any piece of clothing that is worn over a strong enough vein (watch, glove, hat, etc.). The device could be powered by the user’s body heat or the motion of the user if they are active enough, and the data would be wirelessly sent to our tablet interface, which nurses can access on each floor of the facility. Currently, the vital signs that would be monitored by this device would be blood pressure, blood oxygen levels, pulse, and body temperature, however, more research could be done to add additional statistics.

The Initial Paper Prototype

The Prototype in Practice

To test our paper prototype we conducted user research. We had three participants complete our test protocol who live with Mykalena, which were held over Zoom. Mykalena was with the participants in her house and was the facilitator. Nate and Zaynah were both observers on Zoom and took notes while watching the participants use the Marvel paper prototype. We did not have a computer role because Marvel replaced the task of a computer.

One of our participants was one of the nursing assistants who we interviewed in our earlier research and the other two are pre-med students who work part-time in hospitals. We chose them to participate because they are familiar with working in living facilities and hospitals and would be familiar with the task of taking vitals and dealing with patient information.

Our protocol was to give the user a few scenarios and to watch how they used our interface to respond to the task. Then, we asked for critique and feedback. The scenarios were as follows:

  • You receive an alert that a patient has unusual vitals, first use the interface to view the alert to see what patient it is regarding. Then, look at the patient’s information and vitals to assess the issue.
  • It’s time to check your patients’ vital signs. You notice a patient’s heart rate is high, check their vitals history for irregularities and issues.
  • Place the sock on a patient and check their vital signs using the interface.

Feedback and Modifications

After conducting our usability tests, we had to reflect on the feedback we received. While most of the comments were compliments, there were a few issues that stood out and needed to be modified before we began work on a final paper prototype. The issues were as follows:

  • Deleting and adding patients

-There is no way to add or remove patients from the system

-This makes the app unusable in a real-world situation

  • Connecting to wearable (Bluetooth)

-Without describing to the user what our product is used for, the interface. might confuse them because we did not include any features regarding how the sock works and connects to our interface

-To fix this we want to include the ability to add a new sock monitor as well as managing the monitors associated with each resident to create a more thorough design

  • Update graph design on the patient information page

-The graph has the ability to show all vitals individually, but it would be nice to implement a feature that allows the graph to display all of the vitals from a particular point in time (vitals history) simultaneously.

-This is important because it would increase efficiency regarding the analysis of vitals history

The modifications resulted in our final paper prototype:

Digital Mockup

https://www.figma.com/file/o1PvK5frfEX4KdMlQwzVAT/Digital-Mockup?node-id=4%3A0

The most important things we kept in mind when transitioning from our paper prototype to our digital mockup was where we could add more detail and how we could make it look like a real interface. Overall, we liked the way our final paper prototype turned out so we went in with a goal to try and emulate it as best as we could through Figma.

Our first task is efficiently taking vital signs. All patients wear a comfortable piece of clothing with an integrated vitals monitor that measures pulse, blood oxygen saturation (SpO2), temperature, and blood pressure, all of which will be wirelessly transmitted to our nurse’s interface application. This would greatly reduce the amount of time that nurses need to spend on collecting vital information, as the process is automated with our design. The wearable monitor alerts nurses of issues and emergencies automatically by detecting unsafe vitals measurements. Our second task is collecting and storing vital data. Each assisted living floor of the facility will have a company device that nurses can use to view current vitals, patient information, and vitals history.

The interface is password protected in order to safeguard the information of the residents.
After logging in, the nurses view a grid of all of the residents living on the corresponding floors the tablet belongs to. An alert icon will appear by a resident if the wearable picks up an issue.
The issues page can be accessed by clicking the alert icon on the upper right-hand corner of the Residents page.
New residents can also be added to the system via the Add Resident page.
Nurses can click on any of the residents on the dashboard or alert page to view more. Here they can then see standard information about them as well as additional helpful statistics made possible by continuous vitals tracking.
Nurses have the ability to filter by the four vitals the sock monitor will track and then a graph is populated on the screen with the last hour of statistics for the chosen vital. The nurse can then expand the graph to view data for the last day, week, month, and year for the resident.
Nurses can make changes to a resident’s information page.
Residents can also be removed from the system, but an additional prompt helps minimize accidentally doing this.

Final Thoughts

From our user research, it is clear that there is a need for an improved method for collecting vitals information from the residents at the Parkshore assisted living community, especially with the challenges imposed by the Covid-19 pandemic. The current method for collecting vitals is time-intensive and unreliable, which commonly leads to inefficiencies in the nurses’ schedules. Our solution to this issue provides the residents with comfortable vitals monitoring via integrated wearable tech that wirelessly and continuously transmits their health data to a convenient interface for the nurses. Not only does this greatly reduce unnecessary contact that could put the lives of the residents at risk, but it also increases the efficiency at which the nurses can monitor vital signs, allowing them to spend more time doing other tasks that have a direct impact on the well-being of the residents. With our solution, the nurses at Parkshore can rest easy in knowing that they will be automatically alerted to any health issues detected by our monitors, giving them the time to respond appropriately.

University of Washington Computer Science, Intro to Human Computer Interaction