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Chelsea and Westminster NHS Trust deploys nurse-led mobile vital signs app

App developed with IT company ThinkShield helps clinicians at London NHS trust to prioritise at-risk patients

Chelsea and Westminster NHS Foundation Trust has gone live with an app that enables clinicians to monitor and record patients’ vital signs on mobile devices. 

The app, called ThinkVitals, was developed by nurses at the trust in collaboration with IT company ThinkShield. It allows nurses and healthcare assistants to record information such as heart rate, temperature, respiratory rate and blood pressure electronically.  

The app then quickly calculates the early warning score, based on National Institute for Health and Care Excellence (Nice) guidelines, and clinicians can get an overview of the ward, being able to prioritise patients based on a traffic light system.

Barry Quinn, the trust’s assistant director of nursing, told Computer Weekly the electronic system is very similar to how vital signs are recorded on paper charts.

The difference is that with the app, clinicians can be “assured that all the scores are added up correctly”, as well as being able to view the patients’ scores, even if they are not physically present on the ward, he said.

“If I’m looking at 35 patients, I can see the red, amber and green rating, so I immediately know which patients should have action plans and need to be dealt with first,” said Quinn.

Development of the app began three years ago, and 18 months ago, the trust began piloting it in its acute assessment unit before rolling it out across all adult inpatient wards about four months ago.

The trust set up a steering group to oversee the app’s development, which included a number of clinicians and IT staff. During the pilot, there were some teething troubles, said Quinn, and it needed “some tweaks”, but implementing it was “very easy”.

“I think the whole project has taught clinicians about introducing a more electronic way of caring for our patients, and they really learnt the benefits of collaboration,” he said. “Nurses are experts in caring for people and need support with the growing need for IT in the clinical setting. Nursing care is a combination of clinical and human skills, supported by IT solutions.”

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The hospital is using Samsung Galaxy tablets, which are small enough to fit in the pockets of nurses’ uniforms. However, Quinn said “they found it a bit heavy, and were also using desktops and computers on wheels”.  

He added: “Some prefer it because it’s a bigger screen. If you’re looking at just one patient, the tablet is fine but if you want to see what’s going on with all of the patients, the desktop is better for my eyes because I can look at all of the patients at once.”

The app uses HL7 message protocols, enabling it to integrate with, and display data from, other systems. So far, though, it integrates only with the trust’s Kainos Evolve electronic document management platform and its core information system, LastWord. Eventually, the goal is for all the trust’s clinical systems to “speak to each other”, said Quinn.

Soon after rolling out the app, the trust conducted an internal survey to obtain feedback. This showed that 95% of nursing staff found the app easy to use and wanted more clinical IT at the trust. Also, 84% wanted all nursing documentation to be digitised, which reduces the risk of losing observation charts and improves confidentiality and security.

The trust is also working on extending the app’s use to record fluid balance. The app itself has the ability to monitor wounds and temperature as well, but Quinn said the key is to introduce the app “bit by bit” to make sure staff are confident in using it. “There is a danger of not embedding it properly before moving on and keep on rolling out new things,” he said.

“I think the whole project has taught clinicians about introducing a more electronic way of caring for our patients, and they have really learnt the benefits of collaboration.”

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