2.1 

Hello and welcome to the second lesson about Oxevision. Here we will be introducing the Oxevision vital signs medical device. This lesson will take approx 15 minutes, and once complete you can move onto lesson 3: How to monitor a patient's activity using Oxevision.

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2.2 

So, what’s this lesson about? During this lesson we will cover:

• How does Vital Signs work on Oxevision?
• How to take a patient’s Vital Signs using Oxevision? 
• What are ‘Blobs’ and how do they work?  
• The Vital Signs trends report.

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2.3 

Introducing Oxevision’s vital signs.This supports staff to perform observations and improve physical health monitoring. The Oxevision vital signs is registered as a class IIa medical device in the UK and Europe. It's important to note: Oxevision does not provide warnings or alerts associated with vital signs; they are spot-check measurements that require the user to complete the workflow. Oxevision vital signs is designed to measure pulse rate and breathing rate in the ranges specified:

• Pulse Rate: 50 to 130 ± 3 beats per minute
• Breathing Rate: 8 to 39 ± 2 breaths per minute, 

Oxevision will not give measurements outside these ranges.

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2.4 

So how do vital signs work in Oxevision?

You are able to obtain contact free vital signs measurements using Oxevision.  These are spot check measurements of vital signs only, the system will not alert or warn you to abnormal pulse and breathing rates. To obtain either a pulse rate or breathing rate, the patient must be still or resting. Pulse rate readings are as accurate as a pulse oximeter +/- 3 beats per minute and breathing rate readings are accurate to +/- 2 breaths per minute.

So how does oxevision detect an individual’s pulse rate? .

When your heart beats, your skin flushes red and the human eye cannot see these "micro blushes" but Oxevision's Vital Signs can. It counts the micro blushes to calculate a pulse rate. So, to obtain a pulse rate reading, there must be visible skin shown.

For breathing rate measurements, visible skin is not needed and can still be collected when a patient is covered, even if they are under a sheet or blanket. The system collects breathing rates by counting the rise and fall of the individual’s chest, similarly to how a nurse would if they carried out an in person observation.

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2.5 

Now let's go through the step-by-steps on how to take vital signs using Oxevision.

Step 1; on the room overview screen, select the room tile of the patient you wish to take vital signs from. The action menu will then be displayed. On this action menu you can access different oxevision features, but for now, let's go to ‘take vital signs’. By selecting this you are using the registered medical device. Please Note: For patient privacy reasons, please proceed with caution if taking a Vital Signs observation when the room tile is orange and displaying “In Bathroom. This workflow must only be accessed as per your organisation's protocols.

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2.6 

Step 2: during this step you will see a clear live video feed into the patient's room that will automatically time out after 15 seconds. Use this live video feed, to confirm that you are taking the reading from the correct person, that they are not in any visible distress, and that they are still. If the patient is moving, please select cancel. You will then be taken back to the overview screen. If this occurs, proceed in accordance with your organisation's protocol. If they are still, then proceed to click “yes”. 

Note: If Oxevision displays “acquiring vitals” you may be unable to complete the observation.

After 15 seconds, the video feed will automatically time out.

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2.7 

Step 3: During the next step you will see a paused image of the clear live feed where you will notice that the system has placed two bright blue circles onto the image. We call these ‘blobs’. Blobs are where the system wants to take its measurements from.
In this step you need to answer the question “Are there blobs which do not touch the body?”. You need to check the image to see where the blobs are located. You may see one or two blobs on the screen, either is normal. Please Note:  If the system has placed one blob on the screen you are likely to only get either a pulse rate or breathing rate. If the system places 2 blobs on the screen you will get both a pulse rate and breathing rate.

You should only proceed with the workflow if all blobs are touching the body.
So, if all blobs are on the body, you would select “No '' as it’s safe to continue. If the system has placed blobs that are off the body then you must select “Yes”. You will then be taken back to the overview screen. If this occurs, proceed in accordance with your organisation's protocol.
Please note, the blobs must be on the intended person’s body to get a reliable reading. If the patient is completely covered, proceed with caution.

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2.8 

Step 4. Once you have selected “No" confirming all blobs are touching the body, a pulse and/or breathing rate measurement will be displayed on the screen. A vitals saved message should appear and then you can select ‘done’,

If you only receive one measurement of either pulse or breathing rate, and you would like to obtain both, please ensure that the patient is still, the blobs are on the body, and visible skin is shown for pulse rates, then retry the observation.

Please note, you must physically record these readings, as per your organisation's protocols, as Oxevision does not link to your Electronic Patient Record. 

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2.9 

Here is a short video demonstrating the step by the steps of how to take vital signs using Oxevision. 

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2.10 

Now we will go through some examples of where blobs do and don’t touch the body and what you should do depending on where they are placed.

• In the first example, are there blobs which do not touch the body?

Yes, the system has placed a blob on the floor to the right of the individual's foot, which means it is not touching the body and it is not suitable to continue. In this example you would select “Yes” you will then be taken back to the overview screen.

• In the second example, are there blobs which do not touch the body?

Yes, the system has placed 1 blob on the patient's body, which would be safe, however if you look closely, the system has placed a second blob on the ceiling light. One of the two blobs is not touching the body so it's not safe to continue as you must ensure that they are both on the patient's body.
In this example you would select “Yes”  you will then be taken back to the overview screen.

• In the third example, are there blobs which do not touch the body?
  No, the system has placed two blobs and both are on the patient's body. Which means it's suitable to take the reading. In this example you would select “No” and proceed to get the individual's pulse rate and breathing rate. 

• In the final example, are there blobs which do not touch the body?
  No, the system has placed one blob touching the individual's body. If you remember from earlier on in the lesson, we mentioned that you are still able to collect a patient's breathing rate even if a patient is completely covered. In this example, you would select “No” and proceed to get the individual's breathing rate. You will just need to ensure you are taking the reading from the correct person, and that there is only one person underneath the cover.

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2.11 

We will now introduce one of the reports you will have access to called the Vital Signs Trends chart. It was created to help provide additional insights which can help inform care planning and physical health monitoring. This report is part of the medical device and also has a class IIa certification in the UK & Europe.

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2.12 

You can view each room’s vital signs trends report by selecting the vital signs trends button on a room’s action menu. 

On the screen is an example of this report. There are two separate charts representing each of the vital signs (pulse and breathing rate). Within each chart, the coloured dots represent all of the completed vital signs observations you and other staff have taken over the last 24 hours using Oxevision. Red dots represent pulse rate measurements, and blue dots represent breathing rates. If you hover over the coloured dots, you will be able to see the specific measurement that was obtained, including the date and the time it was taken. 

You will also notice a grey trend (grey diamonds), plotted along both charts. Oxevision is constantly working in the background, calculating 5 minute averages of the individual’s vital signs. The individual's Vital Signs must be recognised by Oxevision for at least 75 seconds of that 5 minute period to show you trends.These provide additional insight into the patient’s recent physical health and may surface any underlying trends which may be of interest to staff. If no trends are shown for a particular time, this is because the system was unable to pick up any vital signs, this  may be because there was too much movement in the room or the room was unoccupied. 

Please note: The vital signs trends reports may show multiple people’s data who have been in the room over the last 24 hours.
The Oxehealth Vital Signs device is designed to measure pulse rate and breathing rate in the ranges specified in the Instruction for Use, and will not give measurements outside these ranges.

You are able to export these reports, in Lesson 3 we will teach you how.

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2.13 

Saving vital signs. As mentioned earlier on in this lesson, Oxevision does not link to your EPR, however you can view the last 24 hours of vital signs observations in the vital signs trends report. 

Vital Signs should save automatically. If saved they will be visible on the relevant Vital Signs Trends chart within the system.

However, if your wifi connectivity drops, Oxevision will try to resave the vital signs and display a “Please wait…” message as shown on the first image.

If the device continues to have insufficient wifi connectivity, the “Vital Signs Failed to Submit” message will be shown and a “Retry” button will appear.

You can then choose to exit but please note that the vital signs you have just taken will not be recorded in the relevant Vital Signs Trends chart if you exit. 

Note: you will need to move into an area with good wifi connectivity before selecting ‘retry’

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2.14 

Here are some key messages for you to please remember about Vital Signs on Oxevision:

• You can take contact-free spot-checks of patients’ vital signs measurements - however, Oxevision will not alert to abnormal pulse rate, breathing rate or those outside the stated ranges in the Oxevision Instructions for Use.  
• The patient must be still and the blobs must be on the body
• The system cannot verify a patient’s identity. It is your responsibility to ensure that vitals are taken from the intended individual. If there are multiple occupants in a room, we advise you to revert to another means of observation.
• Oxevision must not be used as the sole basis for making clinical decisions or recommendations
• Some products or environmental factors can interfere with the Oxevision system by creating other signals in the room (vibrations/flashes/light), which the software can misinterpret. If you remember when we went through the examples of blobs earlier in this lesson, in example 2 the system had placed a blob on the ceiling light. The flashes from the ceiling light may have caused the system to misinterpret those signals and caused a blob to appear on it.  Other devices where this can happen include: hoists, sleep apnoea devices, mobile and tablet devices, fans, airflow mattresses, sunlight and curtains. If these devices are present please be cautious when using the system by ensuring that the blobs only appear on the patient's body when you are taking a vital signs observation. For more information, please refer to the Instructions for Use
• If anything looks wrong, select “Cancel” and revert to another means of observation.

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2.15 

Thank you, you've now completed lesson 2: How to take a patient's vital signs using Oxevision.

Please take some time to read the key messages below the video then mark the lesson as complete.

Then move onto lesson 3: How to monitor a patient's activity using Oxevision.

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