Background Bispectral Index (BIS) monitoring uses electroencephalographic data to measure patients‘ level of consciousness. Our I-CAN-CARE study sought to explore the use of BIS in palliative care. Our preliminary work indicated that while a few clinicians had some reservations about the technology, patients and relatives did not. We therefore proceeded to investigate BIS in practice.
Objective To evaluate the feasibility of trialling BIS monitoring with conscious UK hospice patients.
Methods We conducted a prospective study of BIS with hospice inpatients, trialling the technology for a period of four hours. Feasibility was assessed against the following a priori criteria: percentage of recruited patients 15%, and three criteria related to BIS specifically: percentage of eligible patients refusing to be approached for technology-related reasons 10%; percentage of technology-related refusals to participate 10%; and rate of non-completion due to the technology 10%.
Results In 12 months, 332 hospice inpatients were screened for eligibility, and 177 (53.3%) deemed eligible for the researcher to approach for consent. For reasons related to the technology, one patient refused approach (1/177); 34 could not be approached for other reasons. Six of those approached (6/142; 4.2%) refused consent due to the technology. In all, 40/142 (28.2%) agreed to participate. Thirty-nine of the 40 recruited were monitored with BIS (it was impossible to monitor the other patient successfully). Two participants (2/39; 5.1%) requested that monitoring stop before the endpoint for reasons relating to the technology.
Conclusions Our findings show that it is feasible and acceptable to conduct research into BIS technology with conscious inpatients on a palliative care unit. The use of BIS did not markedly limit recruitment or retention, and most participants were content. Our analysis will proceed to examine data from these participants on the utility of BIS monitoring.
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