Patient Comfort, Perceived Safety, and Willingness to Use Wearable Continuous Monitoring in Emergency Care

With increasing patient volume and limited resources across the hospital, the earliest physiologic signals of clinical deterioration often occur where continuous monitoring is unavailable (e.g., hallways, waiting rooms, perioperative holding bays, and general medicine floors). Patient perceptions of wearable continuous monitoring devices are limited but will be vital to broader implementation. The objective was to evaluate patient comfort, perceived safety, and willingness to use wearable continuous monitoring as a prerequisite to broader implementation.

We performed a prospective observational study in a single academic ED of adult patients who wore a Caretaker wearable continuous monitoring device. After monitoring, participants completed a brief survey including 0-10 comfort score (lower scores indicating greater comfort), 5-point Likert safety item, and willingness to wear the device again; free-text comments optional. Start location, time from ED arrival to device placement, and final disposition were abstracted. We summarized available data using medians with interquartile ranges (IQR) and proportions with 95% confidence intervals (CI); comments underwent inductive thematic analysis.

We enrolled 242 patients (median age 59 years; IQR 39-71; n=230). Monitoring began in provider-in-triage rooms for 62% (149/240) and in waiting/staging areas for 27% (64/240); hospital admission occurred in 39% (89/230). Median arrival-to-placement time was 48 minutes (IQR 29-80; n=187). Comfort scores indicated high comfort (median 1; IQR 0-4; n=219). Most patients agreed/strongly agreed they felt safer while monitored (155/218, 71%; 95% CI 65-77) and would wear again (208/217, 96%; 95% CI 92-98). No adverse events were documented (0/231). Comments (n=67) highlighted overall comfort, minor discomfort from wrist straps or finger sensors (including sweating, itchiness), and occasional concerns about blood pressure accuracy or device interruptions.

ED patients reported high acceptability of wearable continuous monitoring, supporting readiness for broader deployment in under-monitored care areas. Patient-identified usability and trust concerns provide actionable guidance for device optimization and future effectiveness studies. Findings from this single academic ED may apply to other hospital settings with limited physiologic monitoring.