Health and medical device development for fundamental care: Scoping review

BackgroundThe use of technology and health and medical devices as a part of fundamental nursing care is increasing. Although involving users in the device development process is essential, the role of nurses in the process has not yet been discussed.ObjectivesTo examine and map what kind of health and medical devices have been developed specifically for fundamental nursing care and to examine the design and development of the devices, particularly focusing on the role of nurses in the process.DesignScoping review.Data sourcesThe Medline, Cinahl, Web of Science, IEEE Explore and ACM DL databasesReview methodsThe databases were searched to identify studies describing health and medical devices developed for fundamental nursing care published between the years 2008–2018 in English language. References of included articles were reviewed for additional eligible studies. Two research team members screened the abstracts and full articles against the predefined inclusion and exclusion criteria. The PRISMA‐ScR checklist was used.ResultsOf the 7223 reports identified, a total of 19 were chosen for the scoping review. Of these, five were further analysed regarding the development process. Main focus areas of the included reports were patient monitoring, pressure ulcer prevention and patient transfer and mobility. Device development process, divided into three phases, was mainly driven by technological expertise and healthcare personnel were mainly involved in the evaluation phases.ConclusionsHealth and medical devices are a crucial part of the healthcare today and nurses are increasingly involved with their use. Most of the devices have been developed mainly by using technological expertise although they are directly aimed at fundamental aspects of nursing care. The results of our review suggest that the expertise of the nurses as the end‐users of the devices could be much more exploited.</p

Acute pain intensity monitoring with the classification of multiple physiological parameters.

Current acute pain intensity assessment tools are mainly based on self-reporting by patients, which is impractical for non-communicative, sedated or critically ill patients. In previous studies, various physiological signals have been observed qualitatively as a potential pain intensity index. On the basis of that, this study aims at developing a continuous pain monitoring method with the classification of multiple physiological parameters. Heart rate (HR), breath rate (BR), galvanic skin response (GSR) and facial surface electromyogram were collected from 30 healthy volunteers under thermal and electrical pain stimuli. The collected samples were labelled as no pain, mild pain or moderate/severe pain based on a self-reported visual analogue scale. The patterns of these three classes were first observed from the distribution of the 13 processed physiological parameters. Then, artificial neural network classifiers were trained, validated and tested with the physiological parameters. The average classification accuracy was 70.6%. The same method was applied to the medians of each class in each test and accuracy was improved to 83.3%. With facial electromyogram, the adaptivity of this method to a new subject was improved as the recognition accuracy of moderate/severe pain in leave-one-subject-out cross-validation was promoted from 74.9 ± 21.0 to 76.3 ± 18.1%. Among healthy volunteers, GSR, HR and BR were better correlated to pain intensity variations than facial muscle activities. The classification of multiple accessible physiological parameters can potentially provide a way to differentiate among no, mild and moderate/severe acute experimental pain