Vital signs for vital people: an exploratory study into the role of the Healthcare Assistant in recognising, recording and responding to the acutely ill patient in the general ward setting

Abstract

HCAs play a significant role in the detection and monitoring of acutely ill patients. Acknowledgement is needed of the contextual factors in the general ward setting which may influence the quality of this process. The educational needs identified by this study can assist managers to improve clinical supervision and educational input in order to improve the quality of care for acutely ill patients.

Vital signs monitoring to detect patient deterioration: An integrative literature review

“…Physical cues of deterioration, such as noisy breathing and agitation, altered skin colour, clammy to touch, and verbalization of feeling unwell, could be detected through physical assessment . These cues are often displayed in patients during the early compensatory period of deterioration, where deviations from baseline vital signs may not be prominent.…”

“…It is therefore crucial for nurses to recognize these early cues and act on them before patients become clinically compromised and develop vital signs abnormalities in the decompensating stage . However, the ability to undertake physical assessment to assess changes in patient's health status was reported by both the quantitative and qualitative studies to be lacking in the non‐registered nursing staff …”

“…With the expansion of the role of registered nurses (RNs), vital signs monitoring is increasingly being delegated to the non‐registered staff . However, concerns with regard to their ability to recognize clinical deterioration have been raised.…”

“…The impact of heavy workload has been identified to influence the quality of vital signs monitoring . With a high nurse‐patient ratio on general wards, nurses reported they are often overwhelmed with the excessive workload to fit in time for the observations .…”

Paid carers: a new research challenge

“…Research to date has looked mainly at comparisons between registered nurses and HCAs (Chang & Lam, 1998;Keeney, Hasson, McKenna, & Gillen, 2005;Pearcey, 2008;Workman, 1996) between student nurses and HCAs (Wakefield, 2000) or it has concentrated on describing HCA roles using case study approaches (Daykin & Clarke, 2000;James, Butler-Williams, Hunt, & Cox, 2010;Kessler et al, 2010;Spilsbury & Meyer, 2004). There is a need for more high quality research to generate knowledge to inform future development of the paid carer workforce, in order to maximise the benefits for patients and service users.…”