VIENNA — Continuous wireless monitoring of vital signs in hospitalized patients reduced major complications and mortality while significantly easing nursing workload, according to findings from a pilot randomized controlled trial.

Findings suggested that replacing intermittent bedside observations with real-time digital monitoring could help close critical gaps in patient surveillance, particularly among older, frail patients with multiple comorbidities occupying internal medicine wards.

Continuous wireless monitoring meant nurse time was reduced by around 24 minutes per patient per day, while major complications and mortality were lower in patients receiving continuous monitoring than those receiving standard observations.

Filomena Pietrantonio, MD, medical director of the Internal Medicine Department at Castelli Hospital in Rome, Italy, presented the results here at the 24th European Congress of Internal Medicine (ECIM) 2026. “Continuous monitoring allows immediate detection of changes in vital parameters so action can be taken before clinical deterioration occurs.”

Closing the Blind Spots in Hospital Care

In routine hospital practice, vital signs are typically assessed at intervals of 4-6 hours, but this approach creates periods during which clinical deterioration may go unnoticed, explained Pietrantonio, adding that these are often referred to as “clinical blind spots.” She explained that subtle physiologic changes can occur between scheduled observations, potentially delaying recognition of deterioration until the next manual check.

In response to this need, Pietrantonio and colleagues evaluated a wireless vital parameter continuous monitoring system designed to provide real-time surveillance with automated alerts. The system continuously measures physiologic parameters including blood pressure, heart rate, respiratory rate, oxygen saturation, posture, and ECG data; and it transmits the data directly to a patient’s electronic health records. Alerts are triggered when predefined thresholds are exceeded, prompting rapid clinical review.

Randomized Trial in High-Risk Patients

The Light Monitoring Study was designed as a randomized controlled trial targeting high-risk internal medicine admissions. Eligible patients for inclusion presented via emergency departments with early warning scores indicating clinical instability, specifically a Modified Early Warning Score ≥ 3 or National Early Warning Score ≥ 5. They were randomized to either continuous wireless monitoring or standard nurse-led monitoring every 4-6 hours.

Although the study initially aimed to enroll 296 patients to ensure adequate statistical power, recruitment was interrupted by the COVID pandemic. Ultimately, 135 patients were included in the final analysis, reducing statistical power but still allowing for meaningful trend analysis, Pietrantonio said.

Patient participants had high care needs. The mean age was approximately 78-80 years, and patients typically had two to four active comorbidities. More than a third of participants in both study arms were classified as having end-stage disease. “These are very complex, critically ill internal medicine patients,” Pietrantonio emphasized, noting that such populations are particularly vulnerable to rapid deterioration.

Signals of Improved Clinical Outcomes

Despite its limited size, the trial demonstrated consistent trends that supported continuous monitoring. Major complications occurred in 31.2% of patients receiving continuous monitoring compared with 37.5% of those receiving standard care. In-hospital mortality was also lower in the monitored group (11.1% vs 17.5%).

Further breakdown of outcomes suggested improvements across multiple clinically relevant endpoints. Rates of sudden death were nearly halved in the monitored group (9.4% vs 17.2%), while repeated readmissions were reduced. Also, monitored patients were discharged with greater stability, leading to no rapid readmissions.

Continuous monitoring was associated with improved detection of complications, including respiratory failure (7.6% vs 4.7%), glycemic decompensation (3.1% vs 1.6%), and care-related infections (4.7% vs 6.2%), conditions that can escalate quickly if not identified early, said Pietrantonio. “These findings suggest that continuous surveillance can reduce critical, undetected events.”

She added that undetected deterioration is reported to occur in approximately 15%-20% of hospitalized patients, underscoring the potential clinical impact of improved monitoring.

Reclaiming Nursing Time

Beyond clinical outcomes, continuous monitoring reduced nursing time spent on manual vital sign measurement by 24.4 minutes per patient per day (P < .001). For a typical ward caring for 20 patients, this equates to more than 8 hours of nursing time saved each day, effectively freeing up an entire shift. “This is not just about technology, it is about how we use time,” Pietrantonio said. “Nurses can focus on patient care rather than repetitive measurement tasks.”

Nursing staff feedback supported these findings. In post-trial surveys, nearly 70% of nurses reported that the system was easy to use after a short familiarization period, and 100% recognized its benefits for patient safety.

The findings suggest that continuous wireless monitoring serves as a “clinical safety net,” said Pietrantonio.

Such an approach may also have important economic implications. “By identifying deterioration earlier, continuous monitoring could reduce the need for escalation to intensive care, where costs are substantially higher and estimated to be up to 10-fold greater than care in internal medicine wards.”

Despite its promise, Pietrantonio reported that some patients experienced discomfort from wearing monitoring devices, and successful implementation requires robust infrastructure, including reliable Wi-Fi connectivity and integration with electronic health records. “Alarm fatigue also remains a concern. Frequent alerts, particularly if not well calibrated, may overwhelm staff and reduce responsiveness over time,” she said, noting that there was room to improve.

AI Still on the Horizon

During the discussion, the session moderator, Alexis Müller-Marbach, MD, head of the Gastroenterology Clinic at Deutsche Clinic Allianz, Düsseldorf, Germany, asked about use of all the data gathered. “As I understand it, the system currently relies on supervision of the data rather than automated AI-driven analysis. Do you plan to incorporate AI in the future?”

“At present, the system is used for real-time monitoring, with alerts prompting clinicians when abnormalities are detected,” Pietrantonio responded. “All data are integrated into the electronic health record, allowing a more comprehensive view of the patient and their clinical trajectory. In the future, this [using AI] could support more personalized management and help reduce complications.”

Pietrantonio and Müller-Marbach reported having no relevant financial relationships.