Make vital signs great again – A call for action

Kellett, John; Sebat, Frank

doi:10.1016/j.ejim.2017.09.018

Cited by 87 publications

(78 citation statements)

References 127 publications

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“…Conversely, more recent studies have established that nurses are aware of the significance of RR (Douglas, Osborne, et al, ; McDonnell et al, ). Measurement of RR is classed as a simple, cost effective and probably the most important vital sign (Kellett & Sebat, ), yet also often called the vexatious vital sign, as time, skill and patience are required (Kellett & Sebat, ; Lovett, Buchwald, Stürmann, & Bijur, ). It has been acknowledged that the reasons why nurses do not monitor RR are complex and multifaceted (Kellett & Sebat, ).…”

Section: Discussionmentioning

confidence: 99%

To identify the factors that influence the recognizing and responding to adult patient deterioration in acute hospitals

Treacy

Stayt

2019

Journal of Advanced Nursing

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Aims To identify factors that influence recognition and response to adult patient deterioration in acute hospitals. Design A mixed‐studies systematic review. Data Sources CINAHL, Medline, and Web of Science were searched for relevant literature published between 2007 – 2018. Review Methods Studies were critically appraised, data extracted and thematically analysed. Results Thirteen papers met the inclusion criteria. Three main themes were identified: (a) Knowledge and understanding of clinical deterioration; (b) Organizational factors; managing deterioration and staffing levels; and (c) Communication; inter‐professional relationships and professional‐patient communication. Conclusion Despite national guidelines, the review findings suggest that the recognition and response to adult patient deterioration in acute hospital settings is sub‐optimal. A multitude of factors influencing the recognition and response to adult patient deterioration emerged from the findings. Impact Patients are receiving sub‐optimal care due to failure in recognizing and responding to patient deterioration in an appropriate and timely manner. Nurses lack knowledge and understanding of deterioration. Organizational factors contribute to inadequate care and communication among professionals was highlighted as challenging. The factors that influence the recognizing and responding to patient deterioration in acute hospitals are multi‐faceted, however this review highlights immediate recommendations for professionals in the acute care setting.

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Section: Discussionmentioning

confidence: 99%

To identify the factors that influence the recognizing and responding to adult patient deterioration in acute hospitals

Treacy

Stayt

2019

Journal of Advanced Nursing

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“…Despite the clear clinical importance of vital sign measurements, there is often missed or inadequate documentation of patient vital sign measurements by healthcare workers and clinical deterioration is detected too late or not at all [5]. A study in Thunder Bay, Ontario, Canada showed that on admission to hospital, all vital signs were measured from 99.6% of 18,853 acutely ill patients [6], [7]. While the hospital's policy was to record vital sign measurements from each patient every six hours, only 82% had a documented second set of vital sign measurements and only 66% had a documented third set of vital sign measurements [6], [7].…”

Section: Problem Statementmentioning

confidence: 99%

“…A study in Thunder Bay, Ontario, Canada showed that on admission to hospital, all vital signs were measured from 99.6% of 18,853 acutely ill patients [6], [7]. While the hospital's policy was to record vital sign measurements from each patient every six hours, only 82% had a documented second set of vital sign measurements and only 66% had a documented third set of vital sign measurements [6], [7]. The development of unobtrusive, automated and continuous monitoring offers the potential to enhance the safety and quality of patient care [8].…”

Section: Problem Statementmentioning

confidence: 99%

“…The four classic vital signals are pulse rate, respiratory rate, body temperature and blood pressure, which have been examined since as early as 1860 and have become part of routine care in most hospitals by 1970 [6]. Today, vital sign monitoring is one of the most common methods of tracking a patient's health improvement or decline; this is because vital signals are the simplest, most inexpensive information gathered from patients and one of the most accurate predictors of clinical deterioration [5], [6], [8], [72]. Early recognition of clinical and physiological deterioration in a subject can indicate the need for treatment and can prevent or reduce serious adverse outcomes [6], [8], [72].…”

Section: Vital Signalsmentioning

confidence: 99%

“…Despite a long history with vital sign monitoring, and the clear benefits of accurate and consistent measurements, patient deterioration is often missed by healthcare workers even though worsening vital signals often precede this deterioration [6]. Vital signal monitoring and documentation has received limited attention regarding medical research, and there exists a lack of knowledge regarding vital signal measurement optimal practices [8].…”

Section: Vital Signalsmentioning

confidence: 99%

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Non-Contact Bed-Based Monitoring of Vital Signs

Bennett¹

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Vital signs are a set of commonly measured signals used internationally as a baseline in medicine and surgery and are one of the most accurate predictors of clinical and physiological deterioration. Despite the clear clinical importance of vital sign measurements, there is often missed or inadequate documentation of patient vital sign measurements. The development of unobtrusive, automated and continuous monitoring offers the potential to enhance the safety and quality of patient care. This thesis details a system that uses multiple modalities to capture data and data processing techniques to extract vital signal measurements and vital signal measurement abnormalities related to subject morbidities. This thesis focuses on the examination, testing and improvement upon a current visible light video processing technique intended to extract vital signal measurements, and expand it's use to thermal infrared video vital signal extraction. Three modalities were used to gather data from healthy adult subjects and older adult inhospital patients: thermal infrared cameras, visible light cameras and pressure sensitive mats. Subjects participated in several experimental procedures including video data capture of faces, hands and feet as well as in-bed pressure mat data capture. This data was subjected to several stages of data processing to extract vital signal measurements, which include pulse, respiration temperature and mobility measurements. Data segmentation using binary masks, level set method, and watershed method were used to identify regions of interest. An adaptive spatio-temporal video processing algorithm, the main thesis contribution, was used to extract vital signal measurements. The developed algorithm was assessed for its performance in vital signal estimation, as well its

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Respiratory rate monitoring in healthy volunteers by central photoplethysmography compared to capnography

Henricson

Glasin²,

Rindebratt³

et al. 2022

Journal of Biophotonics

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Monitoring of respiration is a central task in clinical medicine, crucial to patient safety. Despite the uncontroversial role of altered respiratory frequency as an important sign of impending or manifest deterioration, reliable measurement methods are mostly lacking outside of intensive care units and operating theaters. Photoplethysmography targeting the central blood circulation in the sternum could offer accurate and inexpensive monitoring of respiration. Changes in blood flow related to the different parts of the respiratory cycle are used to identify the respiratory pattern. The aim of this observational study was to compare photoplethysmography at the sternum to standard capnography in healthy volunteers. Bland Altman analysis showed good agreement (bias −0.21, SD 1.6, 95% limits of agreement −3.4 to 2.9) in respiratory rate values. Photoplethysmography provided high‐quality measurements of respiratory rate comparable to capnographic measurements. This suggests that photoplethysmography may become a precise, cost‐effective alternative for respiratory monitoring.

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Make vital signs great again – A call for action

Cited by 87 publications

References 127 publications

To identify the factors that influence the recognizing and responding to adult patient deterioration in acute hospitals

To identify the factors that influence the recognizing and responding to adult patient deterioration in acute hospitals

Non-Contact Bed-Based Monitoring of Vital Signs

Respiratory rate monitoring in healthy volunteers by central photoplethysmography compared to capnography

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