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Emergency nurses' decisions regarding frequency and nature of vital sign assessment

Lambe, Katherine, Currey, Judith and Considine, Julie-Anne 2016, Emergency nurses' decisions regarding frequency and nature of vital sign assessment, Journal of clinical nursing, vol. 26, pp. 1-11, doi: 10.1111/jocn.13597.

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Title Emergency nurses' decisions regarding frequency and nature of vital sign assessment
Author(s) Lambe, Katherine
Currey, JudithORCID iD for Currey, Judith
Considine, Julie-AnneORCID iD for Considine, Julie-Anne
Journal name Journal of clinical nursing
Volume number 26
Start page 1
End page 11
Total pages 11
Publisher Wiley
Place of publication London, Eng.
Publication date 2016
ISSN 1365-2702
Keyword(s) clinical deterioration
emergency department
emergency nursing
patient assessment
patient safety
risk assessment
vital signs
Science & Technology
Life Sciences & Biomedicine
Summary AIMS AND OBJECTIVES: To explore the factors emergency nurses use to inform their decisions regarding frequency and nature of vital sign assessment. BACKGROUND: Research related to clinical deterioration and vital sign assessment in the emergency department is in its infancy. Studies to date have explored the frequency of vital sign assessment in the emergency department; however, there are no published studies that have examined factors that emergency nurses use to inform their decisions regarding frequency and nature of ongoing vital sign assessment. DESIGN: A prospective exploratory design was used. Data were collected using a survey consisting of eight patient vignettes. METHODS: The study was conducted in one emergency department in metropolitan Melbourne. Participants were emergency nurses permanently employed at the study site. RESULTS: A 96% response rate was achieved (n=47/49). The most common frequency of patient reassessment nominated by participants was 15 or 30 minutely, with an equal number of participants choosing these frequency intervals. Abnormality in initial vital sign parameters was the most common factor identified for choosing either a 15 or 30 minute assessment interval. Frequency of assessment decisions were influenced by years of emergency nursing experience in one vignette and level of postgraduate qualification in three vignettes. Heart rate, respiratory rate and blood pressure were all nominated by over 80% of participants as vital signs that participants considered important for reassessment. The frequency and nature of vital signs selected varied according to vignette content. There were significant negative correlations between assessment of conscious state and years of nursing experience and assessment of respiratory rate and years of emergency nursing experience. Level of postgraduate qualification did not influence selection of parameters for reassessment. CONCLUSION: Emergency nurses are tailoring vital sign assessment to patients' clinical status and nurses are integrating known vital sign data into vital sign decision making.
Language eng
DOI 10.1111/jocn.13597
Field of Research 111004 Clinical Nursing: Tertiary (Rehabilitative)
1110 Nursing
1701 Psychology
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Wiley
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Document type: Journal Article
Collection: School of Nursing and Midwifery
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