Venous needle dislodgement (VND) is a major healthcare safety concern in patients undergoing hemodialysis. Although VND is uncommon, it can be life-threatening. The main objective of this study was to implement a real-time multi-bed monitoring system for VND by combining a novel leakage-detection device and IoMT (Internet of Medical Things) technology. The core of the system, the Acusense IoMT platform, consisted of a novel leakage-detection patch comprised of multiple concentric rings to detect blood leakage and quantify the leaked volume. The performance of the leakage-detection system was evaluated on a prosthetic arm and clinical study. Patients with a high risk of blood leakage were recruited as candidates. The system was set up in a hospital, and the subjects were monitored for 2 months. During the pre-clinical simulation experiment, the system could detect blood leakage volumes from 0.3 to 0.9 mL. During the test of the IoMT system, the overall success rate of tests was 100%, with no lost data packets. A total of 701 dialysis sessions were analyzed, and the accuracy and sensitivity were 99.7% and 90.9%, respectively. Evaluation questionnaires showed that the use of the system after training changed attitudes and reduced worry of the nursing staff. Our results show the feasibility of using a novel detector combined with an IoMT system to automatically monitor multi-bed blood leakage. The innovative concentric-circle design could more precisely control the warning blood-leakage threshold in any direction to achieve clinical cost-effectiveness. The system reduced the load on medical staff and improved patient safety. In the future, it could also be applied to home hemodialysis for telemedicine during the era of COVID-19.
【저자키워드】 Hemodialysis, venous needle dislodgement, blood leakage detection, multi-bed monitoring system, Internet of Medical Things (IoMT), 【초록키워드】 COVID-19, feasibility, hospital, Telemedicine, dialysis, patient safety, sensitivity, Hemodialysis, Accuracy, healthcare, Patient, Internet, experiment, threshold, questionnaire, platform, Blood, clinical study, Worry, high risk, medical staff, Volume, Candidates, subject, life-threatening, core, load, MONITOR, analyzed, detect, recruited, evaluated, reduced, changed, automatically, prosthetic, 【제목키워드】 sensor, novel, leakage, Multiple, System, Ring,