Use of a mobile application to monitor drain sites and surgical wounds after discharge from acute care - A feasibility study in Singapore.

Purpose: This study aimed to demonstrate the compliance, feasibility, and acceptability of telehealth monitoring among surgical patients discharged with wounds or drains.

Methodology: This is a cross-sectional feasibility study. Post-surgical breast, plastic, and hepatobiliary patients with wounds and/or surgical drains were recruited using convenience sampling. The control group received conventional care which consisted of daily telephone follow-up. The intervention group used a mobile wound application to take wound and drain images, report drainage amount and symptoms. Compliance was assessed by measuring the percentage of actual to expected patient entries, feasibility was assessed by comparing detection of abnormalities and unexpected hospital visits, and acceptability was assessed by subjective feedback from nurses and patients from the intervention group.

Results: 59 patients were recruited, with 30 patients in the control group and 29 patients in the intervention group. 9 specialty nurses were involved in the patients' post-discharge care. The mean compliance rate for the hepatobiliary, breast and plastic patients were 89.9 %, 89.5 % and 75.9 % respectively. 4 patients from the intervention group (13.8 %) and 6 patients from the control group (20.1 %) were flagged as having potential abnormalities. As for unexpected hospital visits, there were 2 (6.9 %) in the intervention group and 1 (3.4 %) in the control group. 25 patients and 9 specialty nurses responded to the feedback survey. 22 patients (88 %) did not face any application issues. 18 patients (72 %) preferred to self-report symptoms via the application rather than to call the nurses and reported feeling safe knowing that they are remotely monitored. Most nurses found the app convenient and timesaving (n = 7, 78 %), with monitoring through pictures as more accurate than phone conversation (n = 8, 89 %).

Conclusion: The results suggest that use of a mobile application by surgical patients discharged with wounds or drains is feasible and serves as a viable monitoring tool.